Barrett's esophagus

Barrett's esophagus is a condition in which the cells of the esophageal lining undergo metaplastic change and resemble cells found in the intestines. This condition is typically caused by chronic gastroesophageal reflux disease (GERD), in which stomach contents frequently back up into the esophagus, irritating and damaging the esophageal lining.

Histopathology of Barrett's esophagus, annotated

Pathophysiology[edit | edit source]

The underlying cause of Barrett's esophagus is thought to be an adaptation to chronic acid exposure from reflux esophagitis. Damaged squamous cells are replaced by columnar cells better suited to handle an acidic environment.

Barrett's mucosa, higher magnification, Alcian blue stain

Diagnosis[edit | edit source]

Barrett's esophagus is diagnosed using endoscopy to directly visualize the esophagus, and biopsy to examine the cells under a microscope.

Symptoms[edit | edit source]

Many individuals with Barrett's esophagus have no symptoms. Those who do have symptoms typically have long-standing GERD, with symptoms including heartburn, regurgitation, and difficulty swallowing.

Treatment[edit | edit source]

The goal of treatment in Barrett's esophagus is to relieve symptoms of GERD, prevent further damage by reducing stomach acid, and monitor for precancerous changes.

Medications: Proton pump inhibitors (PPIs) are commonly used to decrease the production of stomach acid.
Endoscopic procedures: These can be used to destroy the Barrett's tissue, promoting the growth of normal esophageal cells.
Surgery: In severe cases, or when precancerous cells are found, part of the esophagus may be removed.

Prognosis[edit | edit source]

Patients with Barrett's esophagus have an increased risk of developing esophageal adenocarcinoma, a type of cancer. Regular surveillance through endoscopy and biopsy is often recommended.

See Also[edit | edit source]

Barrett's esophagus Resources
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