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.
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.
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.
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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