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Chapter: Medical Surgical Nursing: Management of Patients With Oral and Esophageal Disorders

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Barrett’s Esophagus - Disorders of the Esophagus

It is believed that long-standing untreated GERD may result in a condition known as Barrett’s esophagus.

BARRETT’S ESOPHAGUS

 

It is believed that long-standing untreated GERD may result in a condition known as Barrett’s esophagus. This has been identified as a precancerous condition that, if left untreated, can result in adenocarcinoma of the esophagus, which has a poor progno-sis. It is more common among middle-aged white men; however, the incidence is increasing among women and among African Americans.

 

Clinical Manifestations

 

The patient complains of symptoms of GERD, notably frequent heartburn. The heartburn is a result of reflux, which eventually causes changes in the cells lining the lower esophagus. The pa-tient may also complain of symptoms related to peptic ulcers or esophageal stricture, or both.

 

Assessment and Diagnostic Findings

 

An esophagogastroduodenoscopy (EGD) is performed. This usu-ally reveals an esophageal lining that is red rather than pink. Biop-sies are taken, and the cells resemble those of the intestine.

 

Management

 

Monitoring varies depending on the amount of cell changes. Some physicians may recommend a repeat EGD in 6 to 12 months if there are minor cell changes. Medical and surgical management is similar to that for GERD. Because this is a condition that is in-creasing in incidence, research is underway to determine the best monitoring and surgical interventions (Mueller et al., 2000; Stein et al., 1999).

 

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