Barrett's Esophagus Diagnosis & Treatment

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Barrett's Esophagus is a condition where epithelium of lower esophagus changes from the normal Squamous to Columnar epithelium due to long standing Gastroesophageal Reflux Disease or GERD. The Changes are histological or at cellular level. 

Causes of Barrett's Esophagus

Cause of Barrett's esophagus is GERD, therefore patients usually complaint of epigastric pain radiating below the sternum with bad metallic taste in mouth. The Barrett's esophagus develop into adenocarcinoma of esophagus with usual rate of progression being 0.5 to 1 percent per year.

Diagnosing Barrett's Esophagus

Diagnosis of Barrett's Esophagus is made by Endoscopy which is performed if the patient has GERD for more than 5 years. Endoscopy is performed regardless of duration of GERD if patient has "Alarm Symptoms" like dysphagia (Difficulty in Swallowing) , odynophagia (pain while swallowing), weight loss, heme positive stools or anemia , elderly patients.

Continuous monitoring with repeat endoscopy is required as Barrett's esophagus can develop into esophageal cancer

Patients with Barrett's Esophagus should undergo repeat endoscopy every 2-3 years to see if dysplasia or esophageal cancer has developed. If the patient has low grade dysplasia endoscopy should be done every 2-3 months to determine the progression of lesion and see whether the low grade dysplasia has progressed to cancer or resolved.

Patients with high grade dysplasia should always undergo distal or lower esophagectomy because of its high rate of progression to  esophageal cancer. 

Barium studies are usually normal in patients with Barrett's Esophagus.

Treatment Of Barrett's Esophagus

Treatment of Barrett's esophagus is done by treating GERD, if endoscopy shows high grade dysplasia distal esophagectomy is required.