Barrett's esophagus - a disease that is caused by the replacement of cells of the upper layer of the esophageal mucosa in the cells that are normally found only in the stomach. That is, stratified squamous epithelium of the esophagus in the lower part is replaced by columnar epithelium of the stomach. This condition increases the risk of cancer cells in the lower esophagus or cardia in the region. In these departments may develop adenocarcinoma of the esophagus or stomach.
This condition was first described by the English surgeon Barrett, on behalf of whom they called the disease. According to some sources Barrett's esophagus occurs in 5-10% of the adult population of the planet.
Barrett's esophagus - is acquired disease. Its development contributes to gastroesophageal reflux (abandonment of the gastric contents into the esophagus), and hiatal hernia. In the case of long-term presence of gastroesophageal reflux mucosal epithelium of the esophagus deteriorates due to the aggressive effects of gastric juice containing hydrochloric acid and the enzyme that breaks down protein - pepsin.
Sometimes it is thrown up into the esophagus and the contents of the duodenum, which contains bile acids and pancreatic enzymes. All these substances are also capable of damaging the lining of the esophagus that does not have that protection, which is in the cells of the stomach and duodenum. In such circumstances, at the place of the destroyed plane of the epithelial cells of the esophagus developing stem cells, which serve as a source of cancer of the esophagus.
Then, these stem cells are transformed into a cylindrical epithelium, which normally covers only the mucosa of the stomach and is more resistant to the action of digestive enzymes, stomach, duodenum, and hydrochloric acid. It is believed that the further transformation of these cells in the tumor cells are necessary prerequisites in the form of genetic mutations and dysfunction of certain genes.
Barrett's esophagus has no symptoms. Patients do not have complaints. Or, if you have gastro-oesophageal reflux disease manifestations are expressed only slightly. Barrett's esophagus should be suspected in the long course of gastro-esophageal reflux, hiatal hernia, in elderly patients.
The diagnosis of Barrett's esophagus is established when X-rays of the esophagus and stomach. But the main method of investigation is fibroezofagogasroskopiya. When changes are detected fibroezofagogasroskopii the lower esophagus. The mucosa of the lower part of the esophagus has the form of a "velvet" or "velvet". This area is painted in bright red against a background of pink normal mucosa of the esophagus.
To clarify the diagnosis is a biopsy. Pieces of esophageal mucosa examined under a microscope and the diagnosis of Barrett's esophagus set upon detection of columnar epithelium. Biopsy of this should be plural.
Sometimes we study, called - chrome esophagoscopy. In the esophagus, first injected dye (toluidine blue, indigo carmine, methylene blue). All of these dyes stain the modified cells, and normal esophageal mucosa is not stained. Then examine the esophagus with esophagogastroscopy.
To confirm the diagnosis using radionuclide study. We study the degree of accumulation of the mucosa of the esophagus drug containing a radioactive element - Technetium-99.
Treatment of Barrett's esophagus.
Patients with Barrett's esophagus is usually performed antireflux treatment with mandatory annual holding fibroesophagogastroscopy. Upon detection of dysplasia is a study carried out every 3 months to detect adenocarcinoma at an early stage. If the foci of dysplasia detected in the patient's young age is recommended surgery.