Barrett's Esophagus - Treatment, Diagnosis and Monitoring
Posted: Friday, December 02, 2005
by Joyce Claflin Harrell
Sleepcliner
About Barrett's Esophagus
Heartburn and indigestion are a burning sensation felt in the upper abdomen or lower chest. Often one will experience a bitter taste in the mouth and a bloated sensation. It is caused by stomach acid backing up into the esophagus -- the muscular tube that connects the throat to the stomach. The lower end of the esophagus enters the stomach at a point called the Lower Esophageal Sphincter (LES), which is a strong muscular ring. The LES allows food and liquid to pass into the stomach, yet should remain tightly closed at all other times. Heartburn occurs when the LES opens at the wrong time. Many people have this occasionally, and it is nothing to be concerned about. However, recurring severe heartburn or indigestion over many years can be harmful, if not properly treated. This is known as Gastroesophageal Reflux Disease (GERD). If GERD goes untreated, there can be acid irritation to the lining of the esophagus, which can result in complications. About ten percent of patients with GERD are found to have a condition called Barrett's esophagus. It is a serious precancerous condition and may later lead to cancer of the esophagus.
There is a difference in the cell structure of the esophagus compared to the stomach or intestines, mainly because they have different functions. It is usually easy for a physician to tell the cells apart when examining the esophagus and stomach. Barrett's esophagus is the abnormal growth of intestinal-type cells above the stomach, into the esophagus. This abnormal growth may actually be a defensive measure since the stomach cells protect the lining from acid. This growth may protect the esophagus against further damage by GERD, explaining why some patients with Barrett's esophagus report their symptoms of GERD improve. Unfortunately, these tissue changes may be a forerunner of cancer of the lower esophagus.
In time, the Barrett's cells may develop into dysplasia which is an abnormal change in the cells. This dysplasia can progress from low grade to high grade and finally to cancer, over a period of a few years. This progression of the disease into cancer occurs in less than 5% of patients with Barrett's esophagus.
Diagnosis
Diagnosis of Barrett's esophagus requires an examination called upper endoscopy or EGD, which is done with the patient under sedation. This examination is done with a thin, lighted, flexible endoscope. Biopsies are performed, so that tissue can later be examined under a microscope. The results of this examination will determine next steps.
Treatment
There are no medications currently on the market that will reverse Barrett's esophagus. However, it is important to treat the associated GERD condition which may slow the progression of the disease.
There are no medications currently on the market that will reverse Barrett's esophagus. However, it is important to treat the associated GERD condition which may slow the progression of the disease.
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Elevate the head of your bed. Simple gravity helps prevent stomach acid from coming back into the throat and protects the esophagus from acid damage. Doctors recommend elevating the head of the bed 6" - 7".
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Relax. Sit down when you eat and chew completely. Play soothing music. Deep breathing, meditation, tai chi, yoga, or massage may also help prevent and relieve heartburn.
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Eat smaller meals.
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Remain upright after eating. Don't bend over or lift heavy objects.
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Avoid bedtime snacks.
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Lose weight.
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Try a lower carbohydrate diet which may lessen your acid reflux disease/GERD symptoms.
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Avoid foods that burn.
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Stop smoking. Nicotine stimulates stomach acid.
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Chew gum. It can increase saliva production and soothe the esophagus.
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Loosen up. Avoid tight belts, waistbands, and other clothing that puts pressure on your stomach.
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Consult with your doctor and/or pharmacist. Some drugs increase your susceptibility to acid reflux aspirin and other non-steroidal anti-inflammatory drugs, estrogen, narcotics, some depression medications and some asthma medications can make your condition worse.
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Don't be misled by wedges or adjustable beds that bend at the waist. They can actually make the situation worse by forcing stomach acid up into the esophagus.
Monitoring
Once diagnosed with Barrett's esophagus, regular monitoring by a physician is required. The physician must perform regular endoscopy exams and biopsies to look for dysplasia. The frequency of these exams depends on how far the disease has advanced. Surgery to remove the lower esophagus will usually be necessary if cancer has been found. Often, when high grade dysplasia is present, surgery is recommended to prevent the cancer from developing.
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Joyce Claflin Harrell is the inventor of the patented Sleepcliner™ bed elevating system. Her web site www.sleepcliner.com offers multiple solutions for elevating the head of your bed, along with links and articles covering a number of chronic conditions, all of which benefit from sleeping with head and chest elevated.
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