Barrett's Esophagus (cont.)
In this Article
- What is Barrett's esophagus?
- Why is there so much interest in Barrett's esophagus?
- What causes Barrett's esophagus?
- Who develops Barrett's esophagus?
- What is the specific abnormality in the inner lining (epithelium) of Barrett's esophagus?
- What about the cancer that occurs in Barrett's esophagus?
- What is dysplasia in Barrett's esophagus?
- What is the risk of developing adenocarcinoma of the esophagus in Barrett's?
- What are the symptoms of Barrett's esophagus?
- How is GERD with or without Barrett's esophagus treated?
- Why is it important to screen patients with GERD to diagnose Barrett's esophagus?
- Why is it critical to be accurate in the diagnosis of Barrett's esophagus?
- What does endoscopic biopsy surveillance in Barrett's esophagus involve?
- How is high grade dysplasia managed?
- How is low grade dysplasia managed?
- What are the experimental approaches for treatment of high grade dysplasia?
- What experimental options are there for Barrett's esophagus WITHOUT dysplasia?
- What does the future hold for Barrett's esophagus?
- Barrett's Esophagus At A Glance
- Find a local Gastroenterologist in your town
What are the symptoms of Barrett's esophagus?
Barrett's esophagus has no unique symptoms. Patients with Barrett's have the symptoms of GERD (for example, heartburn, regurgitation, nausea, etc.). The general trend is for Barrett's patients to have more severe GERD. However, not all Barrett's have marked symptoms of GERD, and some patients are detected accidentally with minimal or no symptoms of GERD.
Heartburn is a burning sensation behind the breastbone, usually in the lower half, but may extend all the way up to the throat. Sometimes, it is accompanied by burning or pain in the pit of the stomach just below where the breastbone ends. The second most common symptom is regurgitation (backup) of bitter tasting fluid. GERD symptoms often are worse after meals and when lying flat.
The refluxed, regurgitated fluid occasionally may enter the lungs or the voice box (larynx), resulting in what are called extraesophageal (outside the esophagus) symptoms (manifestations) of GERD. These symptoms include:
For reasons not fully understoood, some GERD patients have minimal heartburn but experience other GERD symptoms, for example, extraesophageal symptoms.
GERD may result in strictures and ulceration of the esophagus. A stricture or narrowing is due to scarring (fibrosis) of the esophagus that may cause difficulty in swallowing (dysphagia). The dysphagia is sensed as a sticking (stopping) of solid food in the chest (in the esophagus), and liquids when the narrowing is severe. Strictures can be treated by stretching them with dilators during endoscopy. Untreated, strictures may promote more spillage of food and/or gastric fluids into the lungs. Uncommonly, massive gastrointestinal (GI) bleeding caused by inflammation of the esophagus may occur. Such bleeding results in vomiting of blood or passage of black or maroon stools. More commonly, however, an inflamed esophagus can cause slow bleeding that is detected when anemia (a low red blood cell count) is found and/or stools are tested for blood.
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