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Barrett's Esophagus

What is Barrett's Esophagus?

Barrett's esophagus is a condition in which the tissue lining the esophagus—the mus­cular tube that connects the mouth to the stomach—is replaced by tissue that is simi­lar to the lining of the intestine. This pro­cess is called intestinal metaplasia. No signs or symptoms are associated with Barrett's esophagus, but it is commonly found in people with gastroesophageal reflux disease (GERD). A small number of people with Barrett's esophagus develop a rare but often deadly type of cancer of the 
esophagus. Barrett's esophagus affects about 1 percent 1 of adults in the United States. The
average age at diagnosis is 50, but determining when the problem started is usually difficult. Men develop Barrett's esophagus twice as often as women, and Caucasian men are affected more frequently than men of other races. Barrett's esophagus is uncommon in children. 

The Esophagus

The esophagus carries food and liquids from the mouth to the stomach. The stom­ach slowly pumps the food and liquids into the intestine, which then absorbs needed nutrients. This process is automatic and 
people are usually not aware of it. People sometimes feel their esophagus when they swallow something too large, try to eat too quickly, or drink very hot or cold liquids. The muscular layers of the esophagus are normally pinched together at both the upper and lower ends by muscles called sphincters. When a person swallows, the sphincters relax to allow food or drink to pass from the mouth into the stomach. The muscles then close rapidly to prevent the food or drink from leaking out of the stom­ach back into the esophagus and mouth. 

What is gastroesophageal reflux disease (GERD)? 

GERD is a more serious form of gastro­esophageal reflux (GER). GER occurs when the lower esophageal sphincter opens spontaneously for varying periods of time or does not close properly and stomach 
contents rise into the esophagus. GER is also called acid reflux or acid regurgitation because digestive juices called acids rise with the food or fluid. When GER occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensa­tion in the chest or throat called heartburn or acid indigestion. Occasional GER is common and does not necessarily mean one has GERD. Persistent reflux that occurs more than twice a week is considered GERD and can eventually lead to more serious health prob­lems. Overall, 10 to 20 percent
of Ameri­cans experience GERD symptoms every day, making it one of the most common medical conditions. People of all ages can have GERD. El-Serag HB. Time trends of gastroesophageal reflux disease: a systematic review.  Clinical Gastroenterology and Hepatology. 2007;5(1):17–26. 
GERD symptoms are often relieved by over-the-counter, acid-reducing agents called antacids. Common antacids include:
• Alka-Seltzer 
• Maalox 
• Mylanta 
• Pepto-Bismol 
• Riopan 
• Rolaids 

Other drugs used to relieve GERD symptoms are anti-secretory drugs such as H2 blockers and proton pump inhibitors. 
Common H2 blockers are:
• cimetidine (Tagamet HB) 
• famotidine (Pepcid AC) 
• nizatidine (Axid AR) 
• ranitidine (Zantac 75) Common proton pump inhibitors are 
• esomeprazole (Nexium) 
• lansoprazole (Prevacid)
•  omeprazole (Prilosec, Zegerid)
• pantoprazole (Protonix) 
• rabeprazole (Aciphex) 

People who have GERD symptoms should consult with a physician. If GERD is left untreated over a long period of time, it can lead to complications such as a bleed­ing ulcer. Scars from tissue damage can 
lead to strictures—narrowed areas of the esophagus—that make swallowing difficult. GERD may also cause hoarseness, chronic cough, and conditions such as asthma. GERD and Barrett's Esophagus 
The exact causes of Barrett's esophagus are not known, but GERD is a risk factor for the condition. Although people who do not have GERD can have Barrett's esophagus, the condition is found about three to five times more often in people who also have GERD. Since Barrett's esophagus is more com­
monly seen in people with GERD, most physicians recommend treating GERD symptoms with acid-reducing drugs. 

 

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