Barrett's Esophagus: A Case Study

Abstract

Barrett’s Esophagus is a condition characterized by damage and cell replacement of the tissues in the lower esophagus often associated with gastroesophageal reflux disease (GERD). Affecting over 5% of the population of the United States, Barrett’s Esophagus is most commonly found among older men who have GERD, are overweight or obese, and who smoke cigarettes. The inner lining of the esophagus, the squamous mucosa, is damaged by stomach acid and replaced with a metaplastic columnar mucosa, which results, symptomatically, in heartburn, indigestion, and chronic cough. Barrett’s Esophagus, in rare cases, can lead to esophageal adenocarcinoma. Research of this cancer link are still in early phases. There are no precise precursors known

Repeated esophageal exposure to stomach acid is often, though not always, linked to GERD, and thus Barrett’s esophagus and GERD are consistently conjoined in clinical consideration. Like GERD, Barrett’s esophagus causes the afflicted person to suffer heartburn, indigestion, and chronic cough. Though not fatal in itself, Barrett’s esophagus has been linked to esophageal adenocarcinoma (Fouad et al, 2014). The condition was observed as early as 1950 and described in a paper published by Numan Barrett. (Cameron, 2001) As it came to light, more cases of columnar lined esophaguses began to be noted until the condition took on the name, “Barrett’s esophagus.” The declaration of the GERD link was made in 1983 (Cameron, 2001). Treatments and preventative measures have been proposed and discussed since 1950, and a lack of a cure has left the condition in an open clinical discussion among

(Spechler & Souza, 2014) In extreme cases, an esophagectomy may be recommended wherein the damaged portion of the esophagus is removed. It is also possible to destroy the damaged tissue endoscopically with a technique called ablation. (Spechler & Souza, 2014) In low grade cases, symptoms can be simply treated and the condition monitored to catch any worsening. Proton pump inhibitors (PPI) may be prescribed to prevent stomach acid from further damaging squamous tissue. (nih.gov, 2017) Other methods such as losing weight, sleeping at an angle, quitting smoking, avoiding certain foods, and using antacids can tame the rise of stomach acid and prevent further damage. (nih.gov, 2014)