 |
 |
 |
|
The esophagus is a muscular tube that carries food from the mouth to the stomach. The stomach makes acid, which participates in the digestion of food. There is a valve between the esophagus and stomach that normally prevents acid and other stomach contents from being refluxed back into the esophagus. However, many people have a weak valve, and acid can reflux back onto the lining of the esophagus eventually resulting in Barrett's esophagus.
Causes & Development
Under normal circumstances the esophagus is lined by a white tissue that is similar to the skin on the forearm, whereas the stomach is lined by a red, mucus-secreting tissue that is resistant to acid. When acid is refluxed onto the white lining of the esophagus, it can cause pain, which can be felt as heartburn or indigestion. If the acid reflux is not treated effectively, it can cause damage to the white lining of the esophagus.
After enough damage, the normal white esophageal lining can become replaced with a red lining that is called "Barrett's esophagus". This red lining secretes mucus and is therefore more resistant to acid than the normal white lining. However, the red lining of Barrett's esophagus is abnormal and differs from the normal red lining of the stomach.
Diagnosis & Tests
The premalignant lining of Barrett's esophagus can be seen at endoscopy and diagnosed by endoscopic biopsy. It is therefore recommended that patients who have chronic heartburn or indigestion undergo endoscopy with biopsy to determine whether or not they have developed Barrett's esophagus.
Complications
In a minority of patients (approximately 5-10%), a subpopulation of cells within the red lining (Barrett's esophagus) can progress to become a cancer.
|
|
 |
|
 |
Risk factors for Barrett's Esophagus:
Barrett's Esophagus suggests the following may be present:
Barrett's Esophagus can lead to: | | | | | Tumors, Malignant |  Esophageal Cancer | The changes in the cells lining the esophagus pose an increased risk for esophageal cancer. For unknown reasons, the incidence of cancers arising in Barrett's esophagus is increasing more rapidly than that of any other cancer in the United States. Unfortunately, most of these cancers are not detected until they have become so large that they are incurable. However, cancers in Barrett's esophagus that are detected when they are early and of small size, have a cure rate that is improved dramatically.
If Barrett's esophagus is diagnosed, regular follow-up endoscopic biopsy evaluations are recommended for the early detection of changes that could lead to cancer. Surgery is the only therapy that has been proven to cure early adenocarcinoma arising in Barrett's esophagus. Therefore, if an early cancer is detected in endoscopic biopsies, surgery is generally recommended to remove the cancer and the premalignant Barrett's epithelium. |
|
| | | | |
Recommendations and treatments for Barrett's Esophagus: | | | | | Diet |  Spicy Foods Avoidance| | Avoid spicy foods or citrus fruits as these can aggravate inflammation in the gullet. |
|
| | | | |
KEY | | Strong or generally accepted link |  | | Proven definite or direct link | | | Likely to help |
GLOSSARY
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Endoscopy
A procedure that uses an Endoscope: Examination with a flexible viewing tube.
Esophagus (Esophageal)
Commonly called the "food pipe", it is a narrow muscular tube, about nine and a half inches long, that begins below the tongue and ends at the stomach. It consists of an outer layer of fibrous tissue, a middle layer containing smoother muscle, and an inner membrane, which contains numerous tiny glands. It has muscular sphincters at both its upper and lower ends. The upper sphincter relaxes to allow passage of swallowed food that is then propelled down the esophagus into the stomach by the wave-like peristaltic contractions of the esophageal muscles. There is no protective mucosal layer, so problems can arise when digestive acids reflux into the esophagus from the stomach.
Gastric Reflux Disease (Gastric Reflux, Gastroesophageal Reflux, Gastro-Esophageal Reflux Disease, GERD)
A common relapsing condition affecting approximately 10% of the U.S. population and caused by an abnormal exposure of the lower esophagus to refluxed gastric contents, causing irritation and injury to the esophageal tissues. GERD develops as a result of relaxations of the transient lower esophageal sphincter. Typical presenting symptoms are heartburn, an epigastric burning sensation and acid regurgitation. However, some patients may present with atypical symptoms such as chest pain, shortness of breath, wheezing, and coughing.
Mucus (Mucous)
The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Last updated: Apr 13, 2008
|
 |
|
|
