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What
is Barrett's Esophagus? |
Barrett's esophagus
is a condition in which the lining of the esophagus changes from its normal lining to a type that is usually found in the intestines.
It is believed that this change is the result of chronic regurgitation (reflux)
of the stomach contents up into the esophagus. The contents of the stomach
contain digestive acid and other chemicals which damage the normal lining
of the esophagus.
In the healing process, the wrong type of cells grow to
repair the damaged areas. This phenomenon is referred to as "metaplasia"
and, in the case of the esophagus, intestinal metaplasia replaces the normal
squamous type cells which line the esophagus. This happens in about 10-15%
of people who have long-term reflux.
Once the metaplastic cells have replaced
the normal ones, the patient frequently feels less discomfort since the
metaplastic areas seem to be less sensitive than the normal tissue. Unfortunately,
patients with intestinal metaplasia are at increased risk to develop cancer
of the esophagus over those without it, so being symptom-free does not equate
with being disease- free. As a matter of fact, patients with Barrett's esophagus
have a 30-125 fold higher risk of developing cancer of the esophagus than
the general population.
Importantly, with proper testing, doctors can detect
these cancers early, before they have spread. There are precancerous stages
that the metaplastic tissue goes through before the development of cancer,
and these precancerous stages are classified as dysplasia (see illustration above). A number of genetic
abnormalities have been discovered in this precancerous state. Dysplasia
is detected by performing endoscopic biopsies from the esophagus.
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