How Do You Diagnose Barretts Esophagus
If you suffer from severe heartburn and GERD, you should be evaluated at the Heartburn Center of South Texas. Our physicians offer each patient a thorough evaluation to ensure that chronic reflux has not progressed to Barretts Esophagus.
An endoscopic examination of your esophagus is usually recommended . While you are sedated, a thin, fiberoptic flexible scope with a camera and light is placed into your throat and into your esophagus. Your physician will be able to view your esophagus using the endoscope. If the lining is red instead of light pink, Barretts Esophagus might be present. A definitive diagnosis is make by taking biopsies of abnormal tissue during the endoscopy using special instruments. These tissue samples will be examined under a microscope by a pathologist to check for abnormal cellular changes, which could indicate Barretts Esophagus or dysplasia.
Why Is Early Detection Important
According to research studies performed at the National Institutes of Health, the incidence of esophageal cancer is increasing at an alarming rate. It is thought that esophageal cancer will become more prevalent than colon, breast, or prostate cancer in the years to come. The prognosis for patients with esophageal adenocarcinoma is poor, with only approximately 13 percent of patients surviving five years from the time of diagnosis. Esophageal cancer is usually diagnosed at an advanced stage, which makes treatment more difficult. Thats why regular monitoring for patients with Barretts Esophagus is so important because steps can be taken to prevent the progression to cancer.
Who Is At Risk For Barretts Esophagus
People with chronic symptoms of GERD, including heartburn, laryngitis, and nausea, are at a higher risk of developing Barretts esophagus. In fact, about 10 percent of people with GERD will develop the condition.
White males who have had long-term GERD are also more likely than others to develop Barretts esophagus, as well as people who smoke or are overweight.
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Interesting Facts About Gerd And Barretts Esophagus
- GERD affects an estimated 25%-35% of the US population .
- 10%-20% of patients with chronic GERD symptoms have Barretts Esophagus.
- 44% of Barretts patients lack consistent severe GERD symptoms.
- Barretts Esophagus patients have 30-125 times greater risk of developing esophageal cancer.
- The incidence of esophageal adenocarcinoma is rising more rapidly than any other cancer, a six-fold increase from 1975 to 2001.
- The prevalence of Barretts Esophagus in the general population is 1.6%, approximately 3.3 million in the United States.
- In an endoscopic series of patients, 0.9%-4.5% had Barretts Esophagus. The prevalence of cancer, high-grade dysplasia, and low-grade dysplasia in Barretts Esophagus are 6.7%, 3.0%, and 7.3%, respectively.
- The incidence rate of cancer, high-grade dysplasia, and low-grade dysplasia in Barretts Esophagus are 0.5%, 0.9% and 4.3% per year, respectively.
- 5% of patients with Barretts Esophagus develop esophageal cancer within 5-8 years of diagnosis.
- The incidence of high-grade dysplasia progressing to cancer is 10% per year.
- The incidence of low-grade dysplasia progressing to cancer is 0.6% per year.
- 53% of patients with cancer/high-grade dysplasia have no dysplasia at their first two scopes.
- Genetic variation in two chromosomes has been linked to the development of Barretts Esophagus.
The Common Barretts Disease Treatment Plan
Here is a common story from my practice: a patient was scheduled to have a colonoscopy and the gastroenterologist suggested he undergo an upper endoscopy at the same time. A week later, the patient received a telephone call: Your biopsies showed Barretts esophagus. He received a prescription for a PPI and was told to come back for a repeat endoscopy next year.
That was the extent of his medical advice.
As so many do, the upset patient turned to the internet and discovered that Barretts is pre-cancerous and that esophageal cancer can be a deadly form of cancer. Terrified, the patient searched for more information and answers, and he eventually found me.
As you will see, the diagnosis of Barretts is often a misdiagnosis. Furthermore, impactful treatment is not with PPIs. Believe it or not, data suggest that long-term use of PPIs increase the risk of developing esophageal cancer. You can beat Barretts, but not with drugs like Nexium or Prilosec.
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What Causes Barretts Esophagus
Multiple factors contribute to Barretts esophagus. Its more common in people with GERD. This chronic condition occurs when stomach contents flow backward into the esophagus. Experts believe the acidic liquid irritates the lining of the esophagus, leading to changes in the tissue. But you can also have Barretts esophagus without having GERD.
How Are Strictures Measured In The Esophagus
Esophageal manometry: This test examines the esophageal muscles and sphincter. A small catheter tube is inserted into the nose and into the esophagus. This catheter measures the muscle and valve function of the esophagus during the swallow. How are esophageal strictures treated? Esophageal dilation is the most common treatment for strictures.
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Diagnosis Of Barretts Oesophagus
Diagnosing Barretts oesophagus involves a number of tests, including:
- endoscopy a thin, flexible tube with a tiny light and camera on the end is inserted down your throat so that the doctor can see inside your oesophagus
- image-enhanced endoscopy the light used to illuminate the oesophagus during an endoscopy can be enhanced with narrow band imaging. This usually involves using:
- a blue light, which enhances blood vessels and can better show areas of concern for dysplasia
- zoom magnification
- a dye, to provide better contrast and visibility
Vitamins For Healing A Damaged Esophagus
If youve suffered damage to your esophagus the tube that leads from your mouth to your stomach you may be able to reverse that damage by ensuring you get enough of certain vitamins. Whether you eat foods that are rich in these vitamins or choose vitamin supplements, you can help your damaged esophagus heal. This can prevent the cells in your esophageal lining from changing in ways that lead to cancer.
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Lifestyle Changes For Barretts Esophagus
Barretts esophagus, a condition in which the tissue that lines the esophagus becomes precancerous, is not reversible. However, there are effective ways to manage gastroesophageal reflux disease, or GERD, a condition doctors believe is associated with Barretts esophagus. Lifestyle changes can help reduce the risk of Barretts esophagus progressing to cancer.
NYU Langone gastroenterologists may recommend lifestyle changes in combination with medication or other treatments, such as endoscopic procedures.
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Does Omeprazole Prevent Barrett’s Esophagus
This is the first long-term study of treatment of Barrett’s oesophagus with omeprazole and only the second with any proton pump inhibitor and has shown that continuous treatment with omeprazole 20 mg for periods of up to 6 years was well tolerated and controlled reflux symptoms but did not lead to significant …
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Symptoms Of Barretts Oesophagus
Barretts oesophagus may not show any noticeable symptoms in itself. However, because the condition usually develops after suffering from GORD for about five years or more, patients may often show signs of GORD.
Signs of GORD include:
Once we know the degree of dysplasia you have, we can recommend treatment options.
Causes Of Barretts Oesophagus
Although the exact cause remains unknown, it is strongly associated with long-term Gastro-Oesophageal Reflux Disease , which can cause the symptom of heartburn. Approximately 1 in 10 patients with GORD will develop Barretts Oesophagus and the risk increases with length and frequency of symptoms. GORD involves reflux of acidic and non-acidic stomach contents into the oesophagus, which irritates and injures the lining .
See our information on Heartburn and Relux for more information on GORD.
Over time, in some patients with GORD, the lining of the oesophagus changes from the normal structure, made up of a type of cells known as squamous epithelial cells, to an abnormal type made up from a different type of cells, known as columnar epithelial cells. Often the lining of the oesophagus starts to resemble the lining of the stomach, in a process known as intestinal metaplasia.
Other risk factors that can lead to Barretts Oesophagus include older age, male sex, family history, obesity, smoking, and a hiatus hernia . Barretts Oesophagus can affect men and women, though it is significantly more common in white men, who have a three fold increased risk for the condition.
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What Causes Gastro Esophageal Reflux In Dogs
Acid reflux in dogs or Gastro Esophageal Reflux can be caused by several factors. Knowledge of these causes will help in early noting of the symptoms. Here are the most common causes of acid reflux in dogs: Rare fragility in the lower esophageal sphincter. Poor positioning of your dog during surgery. Grains or legumes in dogs diet.
Barretts Oesophagus And Diet
It may help to keep a food and , to find out which foods make your symptoms worse. Everyones different, but some people find that fatty, spicy or acidic foods, alcohol and caffeine can cause indigestion and reflux. Depending on the findings from your diary, you may find it helpful to:
- grill foods instead of frying
- avoid fatty and processed meats and cheese
- cut down on coffee, chocolate and soft drinks containing caffeine, including energy drinks
- cut down or avoid alcohol and fizzy drinks
- avoid acidic foods, such as tomatoes, citrus fruits and juices
- avoid spicy foods
- avoid acidic sauces and condiments, such as ketchup, mustard and vinegar
Your eating patterns can also affect your symptoms. So you may find it helpful to eat regular meals, particularly making sure you have breakfast, and avoid snacking late in the evening.
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Is There Any Diet Advice For Barretts Esophagus
- Question
- I have GERD and was recently diagnosed with Barretts esophagus. I am working with my doctor to keep it under control. Is there any diet advice for Barretts esophagus? Also, I used to love eating chocolate but now avoid it as it provokes heartburn. Is it OK to eat carob as a substitute for chocolate?
Adapted from IFFGD Publication: Barretts Esophagus and Diet and IFFGD Publication: Do I Need Another Endoscopy? by J. Patrick Waring, MD, Digestive Healthcare of Georgia, Atlanta, GA.
Radiofrequency Ablation In Barretts Esophagus May Prevent Esophageal Cancer
Treatment of Barretts esophagus with radiofrequency ablation appears to keep the condition from progressing to esophageal cancer. These findings were published in the Journal of the American Medical Association.
Barretts esophagus is a pre-cancerous condition of the esophagus. It means that there is a type of cell called columnar epithelial cells present in the surface lining of the lower esophagus. Typically, the surface lining of the lower esophagus should only contain squamous cells however reflux of stomach contents, especially acid, into the esophagus causes these squamous cells to be replaced by columnar epithelial cells more similar to those found in the stomach and intestines.
Barretts esophagus can have different levels of whats known as dysplasia, or number of abnormal cells. In low-grade dysplasia, some of the cells look somewhat abnormal under the microscope this is a very early form of pre-cancer of the esophagus. In high-grade dysplasia, some of the cells look very abnormal under the microscope this is a more advanced pre-cancer of the esophagus than low-grade dysplasia.
Effective treatment of Barretts esophagus can keep the condition from progressing to esophageal cancer. But because relatively few cases of Barretts esophagus progress to cancer, many patients are not actively treated and instead undergo surveillance until signs of progression.
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Causes Of Barrett’s Oesophagus
Barrett’s oesophagus is caused by long-term reflux of acid and bile. This is when stomach acid and digestive juices come up from your stomach into your oesophagus.
Usually, stomach contents are kept in your stomach by a muscular valve. If you have Barrett’s oesophagus, this valve may have become weak or moved out of place. Acid and bile from your stomach can then leak upwards. The cells lining your oesophagus become inflamed and damaged. They eventually get replaced by new cells which are more like the cells that line your stomach. This is your bodys way of protecting the lining of your oesophagus from further damage.
You’re more likely to get Barretts oesophagus if you have long-term reflux and you:
Only about one in every 10 people with chronic reflux go on to develop Barrett’s oesophagus. You’re more likely to develop it if youve had severe reflux symptoms for many years.
Causes & Risk Factors
The exact cause of Barretts esophagus is unknown. However, there are several known risk factors that increase your chance of developing it.
Risk factors for Barretts esophagus include:
- Gastroesophageal reflux disease . The long-term flow of stomach acid into your food pipe irritates the tissue. Over time, that damages the esophageal cells and, in some people, the body turns them into cells like those of the intestines. This happens in 10 to 15 percent of people who have GERD.
- In particular, large amounts of belly fat increase your risk of developing Barretts esophagus.
- Smoking or being a former smoker
- Being over the age of 50
- Genetics, or a family history of the disease or esophageal cancer
- Being Caucasian
Interestingly, there are things that may protect you against Barretts esophagus. Researchers dont know why these seem to protect some people from developing the condition. Possible factors that may decrease your risk include:
- having a Helicobacter pylori infection
- taking aspirin or nonsteroidal anti-inflammatory drugs often
- eating a diet high in fruits, vegetables and some vitamins
Other than eating a diet high in fruits, vegetables and helpful vitamins, it is not recommended that you try to use medicines or get an H. pylori infection to try to avoid Barretts esophagus.
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Preparing For An Appointment
If youre experiencing severe chest pain that lasts more than a few minutes or if you suspect you have food lodged in your esophagus or are unable to swallow, get emergency medical care.
If you have other signs or symptoms of esophagitis, youll likely start by seeing your primary care doctor. For some diagnostic tests, your doctor may refer you to a specialist in digestive system disorders or an allergy specialist . Preparing for your appointment with your doctor or a specialist will help you make the best use of your time.
How Often Does Barretts Esophagus Turn Into Esophageal Cancer
Having Barretts esophagus slightly increases your risk of developing esophageal adenocarcinoma, a cancer of the esophagus. If diagnosed with Barretts esophagus, it is important to have regular exams on your esophagus to detect precancerous cells. If the cells are caught early, they can be treated before they spread.
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If I Have Barretts Esophagus Will I Get Cancer
Barretts esophagus is a precancerous condition that may lead to esophageal adenocarcinoma. This type of cancer is rare.
Most people with Barretts esophagus dont have to worry over 90% wont develop esophageal adenocarcinoma. However, its important to monitor the condition. That way, your healthcare provider can detect any signs of cancer at an early stage.
Things Patients Can Do
Currently, there are no medications to reverse Barretts esophagus. However, it appears that treating the underlying GERD may slow the progress of the disease and prevent complications.Following are some things the patient can do to help reduce acid reflux and strengthen the LES.
- Avoid eating anything within three hours before bedtime.
- Avoid smoking and tobacco products. Nicotine in the blood weakens the LES.
- Reduce consumption of fatty foods, milk, chocolate, mints, caffeine, carbonated drinks, citrus fruits and juices, tomato products, pepper seasoning, and alcohol.
- Eat smaller meals. Avoid tight clothing or bending over after eating.
- Review all medications with the physician. Certain drugs can actually weaken the LES.
- Elevate the head of the bed or mattress 6 to 8 inches. This helps to keep acid in the stomach. Pillows by themselves are not very helpful. Wedging pillows under the head tends to bend the body at the waist which can push more fluid back up into the esophagus.
- Lose weight if overweight. This may relieve upward pressure on the stomach and LES.
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Common Causes Of Esophagitis
First of all, the majority of cases of esophagitis are caused by the effects of gastroesophageal reflux.
The acidic fluid rises from the stomach up the esophagus. Therefore, it causes irritation in the tissues.
Some factors that may lead to this problem are:
- Excessive consumption of alcohol and cigarettes,
- Prolonged use of medication,
Unfortunately, this condition can cause several complications. These include:
- Scarring or tightening of the esophagus,
- Tearing of the tissue covering the esophagus,
- Barretts Oesophagus, a condition which causes changes in the cells of the esophagus, which increases the risk of cancer.
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What Are The Symptoms Of Stomach Inflammation
Inflammation of stomach can present itself with heartburn, nausea, acid regurgitation in the throat or even vomiting. Other symptoms of stomach inflammation include pain in stomach in localized spots, which may be better or worse after eating. There may be a feeling of fullness in the upper abdomen and burning pain in stomach, while some may not have any symptoms at all.
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Chronic gastritis is found in two subjects. In malignant anemia patients, there is an autoimmune cause. Severe gastrointestinal trauma, such as gastric atrophy accompanied by complete or incomplete loss of wall cells, cause gastric acid deficiency or absence of acid. There are three types of autoantibodies against the wall cells. In the elderly with no malignant anemia, there are also 60% of cases with autoantibodies against the wall cells, but no antibodies against the intrinsic factor. Very few cases have autoantibodies against gastrin secretory cells. Patients in this group often have a gastric ulcer, which may be due to dyspnea of the pyloric sphincter and reflux of bile acid.
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