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Barrett's esophagus

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Barrett's esophagus refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagusthought to be caused by damage from chronic acid exposure, or reflux esophagitis. Barrett's esophagus is found in about 10% of patients who seek medical care for heartburn (gastroesophageal reflux). It is considered to be a premalignant conditionand is associated with an increased risk of esophageal cancer.

The condition is named after Dr Norman Barrett (1903-1979), Australian-born British surgeon at St Thomas' Hospital, who described the condition in 1957.

Inhaltsverzeichnis

  • 1 Treatment
  • 2 Pathology
  • 3 Reference
  • 4 External links

Treatment

Current recommendations include routine endoscopyand biopsy(looking for dysplastic changes) every 12 months or so while the underlying reflux is controlled with H2 antagonistsor proton pump inhibitordrugs in combination with measures to prevent reflux. In severe dysplasia, lasertreatment is being used, whereas overt malignancy may require surgery, radiation therapy, or systemic chemotherapy. There is presently no reliable way to determine which patients with Barrett's esophagus will go on to develop esophageal cancer.

Pathology

Barrett's esophagus is marked by the presence of columnar cellepitheliumin the lower esophagus, replacing the normal squamous cellepithelium—an example of metaplasia. The columnar epithelium is better able to withstand the erosive action of the gastric secretions; however, this metaplasia confers an increased cancer risk of the adenocarcinomatype.

The metaplastic columnar cells may be of two types: gastric (similar to those in the stomach) or colonic (similar to cells in the intestines). A biopsy of the affected area will often contain a mixture of the two. Colonic-type metaplasia confers a higher risk of malignancy.

The metaplasia of Barrett's esophagus is visible grossly through a gastroscope, but biopsy specimens must be examined under a microscopeto determine whether cells are gastric or colonic in nature.

Reference

  • Barrett NR. The lower esophagus lined by columnar epithelium. Surgery 1957;41:881-894. PMID 13442856.

External links

  • Who Named Itsynd/829
  • NIDDK
  • Johns Hopkins Barrett's Esophagus Web site
  • Mayo Clinic
  • GPnotebook422903810
  • FPnotebookGI59de:Barrett-Syndrom

sv:Barrets esofagus

Retrieved from "http://en.wikipedia.org/Barrett%27s_esophagus"



This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Barrett%27s+esophagus Wikipedia article Barrett's esophagus.

 
  All text is available under the terms of the GNU Free Documentation License