What is Barrett’s esophagus?
To understand Barrett’s esophagus it is necessary to first understand gastric reflux disease (GERD). GERD is a frequent illness, presented in equal proportion in men and women, and at any age. The disease is triggered by various factors as are: bath eating habits, intake of fatty food, foods high on carbs, irritants, and conservatives; smoking, alcohol, and soda intake. GERD symptoms are not limited to the sensation of heartburn or chest pain; even burping can be indicative of the disease. Some individuals can have symptoms not very apparent of the disease, such as those with chronic coughing, allergies beginning at old age, vertigo, and frequent throat sickness.
As a result of the reflux, the individual is at risk of developing changes in the cellular structure that lines the interior of the esophagus, primarily the lower segment. The constant exposure to a mix of acid and food in process of digestion causes changes in the cells that results in cells that are identical to the ones in the small intestine –– this is referred to as Barrett’s esophagus. This lesion is associated with cellular changes that trigger esophageal cancer.
Who is more prone to having Barrett’s esophagus?
It can occur in any individual who suffers of GERD during prolonged periods of time; however, it is more prevalent among people who are overweight, smokers, and chronic drinkers.
What are the symptoms of Barrett’s esophagus?
In spite of no single distinctive symptom, heartburn becomes more common, as well as chronic cough, sensation of tightness in the chest, or difficulty swallowing. However, a large majority of patients with Barrett’s have no symptoms.
How is Barrett’s diagnose?
It is imposible to diagnose based on symptoms, radiologic tests, or blood tests. The endoscopy is the most effective method for detections of Barrett’s.
Barrett's esophagus seen with a high definition white light endoscope
Barrett's esophagus adding Electronic Chromoendoscopy.
Barrett's esophagus adding electron Chromoendoscopy and Magnification
What is the treatment for Barrett’s?
Initially, the GERD must be treated in order to stop the progression of disease to a hog-grade dysplasia or cancer. Once the diagnosis of Barrett’s is established, there are various methods available for its treatment, all of which are performed through an endoscopy.
- Endoscopy with ligation. The Barrett’s tissue is trapped with rubber bands to cause necrosis and death of the affected tissue. This tissue becomes detached, along with the rubber band and left behind is scar tissue that gives way to healthy tissue.
- Endoscopy with ablation using argon plasma. A catheter is moved through the endoscope used to apply argon gas that is heated up with electricity to causes the affected tissue to evaporate. Only a scar is left behind, which is replaced by healthy tissue..
- Endoscopic Submucosal Dissection (ESD). This is only preferred when complications due to Barrett’s arise, such as low- or high-grade dysplasia. This is a minimally invasive surgery completely performed through an endoscope. During the procedure, endoscopic vision allows the lesion to be identified, marked, and removed using electrocautery to cut the affected tissue down to 2mm of depth with great precision. The patient’s recovery after the procedure is almost immediate. The patient must remain hospitalized for 24 hrs after the procedure.