Barrett’s disease or Barrett’s esophagus (BE) is a transformation of the mucosal epithelium of the lower esophagus, which is the transit zone to the gastric mucosa, and is the part in which there is a change from esophageal mucosa to an epithelium more similar to that of the intestinal mucosa.
This has a higher frequency of diagnosis in people affected by gastroesophageal reflux disease, which is related to an increased possibility of developing esophageal cancer. In order to prevent it, it is recommended to perform periodic controls for the evaluation of precancerous cells, which can be treated after a diagnosis of esophageal cancer. Dr. Ignacio Calleja Kempin, General Surgeon and Expert in Liver Surgery, Pancreatic Surgery, Bariatric Surgery and Laparoscopy, explains in more detail the treatment and prevention of Barrett’s esophagus disease.
What is the treatment for Barrett’s esophagus?
Barrett’s esophagus disease is diagnosed by an endoscopy test with biopsy, which should not cause alarm. Causes that may be related to the symptom of gastroesophageal reflux (GERD) should be sought and followed up with serial endoscopies, especially in patients over 50 years of age with chronic symptomatology.
The sooner a diagnosis of this problem is made, it should be possible to implement an appropriate medical treatment, with which the pH of the gastric juice can be lowered and in some cases antireflux surgery can be recommended, once the severity of GERD has been studied by 24-hour pH-metry.
Symptoms prior to diagnosis of Barrett’s esophagus
Barrett’s esophagus and gastroesophageal reflux disease have a number of similar symptoms, most notably a burning sensation in the lower chest area, difficulty and/or difficulty in swallowing, and the possibility of regurgitation or vomiting of acidic gastric juices.
Within the picture of symptoms related to Barrett’s disease, there are also a series of risk factors that contribute to its development, such as the patient’s increasing age, obesity, family history of Barrett’s esophagus. Furthermore, these factors are accentuated if the patient is male and of Caucasian ethnicity.
Differences between gastroesophageal reflux and Barrett’s esophagus disease
Gastroesophageal reflux (GER) is the passage of gastric juice into the esophagus; Barrett’s esophagus disease is the transformation of the esophageal mucosa usually by the phenomenon of gastroesophageal reflux.
In principle, the intensity of GER symptoms, such as heartburn or retrosternal burning, does not imply the occurrence of BE, nor does little symptomatology imply that there is no BE. Thus, a proper diagnosis should be made in symptomatic patients and especially in patients over 50 years of age who have had significant heartburn or who have required regular use of medications to control heartburn for several years.
How Barrett’s esophagus can be prevented
The prevention of Barrett’s esophagus is directly related to the prevention of Gastroesophageal Reflux, avoiding diets and situations that can produce an elevation of gastric pH and increase the relaxation of the lower esophageal sphincter, which cannot be achieved if the patient drinks coffee, alcohol, tobacco, chooses a high-fat diet, or has obesity, among other risk factors.
Once Barrett’s disease, or BE, is detected, in some cases its progression can be halted or even reversed by medical or surgical treatment, through anti-reflux surgery.