Barrett's Esophagus - Experience

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What is Barrett's esophagus?

Barrett's esophagus is a complication of chronic gastroesophageal reflux disease (GERD), primarily in white men. GERD is a disease in which there is reflux of acidic fluid from the stomach into the esophagus (the swallowing tube). GERD most commonly causes heartburn.

There are two requirements for the diagnosis of Barrett's esophagus. The requirements necessitate an endoscopy of the esophagus. During endoscopy, a long flexible tube with a light and camera at its tip (an endoscope) is inserted through the mouth and down into the esophagus to view and biopsy (sample tissue from) the lining of the esophagus. The two requirements are:

  1. At endoscopy, an abnormal pink lining should be seen as replacing the normal whitish lining of the esophagus. This abnormal lining extends a short distance (usually less than 2.5 inches) up the esophagus from the gastroesophageal junction (the GE junction, which is where the esophagus joins the stomach).
  2. Microscopic evaluation of the biopsy of this abnormal lining should shows that the normal lining cells of the esophagus have been replaced by intestinal type lining cells, including mucus-producing cells called goblet cells. Other cells also are present, some of which resemble cells that line the stomach. However, if intestinal goblet cells are not present, the diagnosis of Barrett's esophagus should not be made.

Barrett's esophagus is officially coded by the Library of Congress for electronic searches of the literature as Barrett esophagus, but Barrett's esophagus (with the apostrophe "s") is the name used universally. The condition is named after a surgeon, Norman Barrett, who described the condition. However, it turns out that his interpretation of the findings was not correct. In 1953, Doctors' Allison and Johnstone actually described this condition as we now understand it, namely that metaplasia was occurring. (Metaplasia, which is discussed below, is the term used when one adult tissue replaces another.) Nevertheless, the condition has been immortalized with Barrett's name.

Initially, it was thought that the Barrett's esophagus consisted of stomach (gastric) tissue replacing the usual squamous tissue lining the esophagus. However, in the mid 70's, Dr. Paull and colleagues published a paper in which they described the mucosa (inner lining) of Barrett's esophagus in greater detail than had been done previously. They pointed out that Barrett's esophagus consisted of a metaplasia in which the normal cells lining the esophagus were replaced by a mixture of gastric and intestinal lining cells. The intestinal-type lining cells also are called specialized columnar cells which include goblet cells. For a number of years, some scientists thought that there were two types of Barrett's; one in which the normal lining was replaced with stomach (gastric) type cells only, and the second in which intestinal cells were present. However, the current belief is that only the presence of intestinal-type goblet cells establishes the diagnosis of Barrett's esophagus, regardless of what other cell types are present.

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See what others are saying

Comment from: missy, 65-74 Male (Caregiver) Published: October 07

My husband just passed away from esophageal cancer. He had asked our PCP to order an endscopy for him and was told we don't do that unless you can't swallow. He had GERD for 5 years. It was diagnosed only because he had pain under his right rib cage and then it took 3 visits to our PCP. The first visit he was given muscle relaxers, the second vist a chest x-ray was ordered and the third visit my husband asked for a gallbladder sonogram and it was then that they saw lesions in his liver. The end result was esophegeal cancer with mets to the liver. He lived 5 weeks. This could have been prevented if the doctor would have ordered a scope for him. I think that endscopy should be as much a part of a physical as a colonscopy. Esophegeal cancer and barret's esophegus is increasing. If a doctor does not want to order an endscopy, then check with another doctor and be persistant. My husband was only 65 yrs. old.

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Comment from: DBS, 55-64 Female (Patient) Published: May 21

I was diagnosed with Barrett"s esophagus about a year ago. I took 800 mg of ibuprofen for fibromyalgia for years. I was also on Celebrex. As a child I took aspirin a lot because of bronchitis. I started having heartburn, pain in my chest, and nausea. I was put on Prilosec, but it continued. At a later time I had a scope done by my liver digestive doctor. My Prilosec was increased. I had a small hernia, GERD, irritable bowel syndrome, and 42 polyps in my stomach. After being diagnosed with Barrett"s I was put on ranitidine and they increased Prilosec. I just returned from the emergency room at the hospital with hard chest pains that radiated to my back, fatigue for 3 days, cough, and problem swallowing; I also had a migraine the day before. I always have congestion. It was caused from all my gastrointestinal problems. My mother died from pancreatic cancer and I"m just afraid after all this, I think I need to get a second opinion as he only wants to scope me every 2 to 3 years. The people with cancerous Barrett"s have all seem to have a fast growing cancer and haven"t lived long.

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