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Both macroscopic (from endoscopy) and microscopic positive findings are required to make a diagnosis. Barrett's esophagus is marked by the presence of columnar epithelia in the lower esophagus, replacing the normal squamous cell epithelium—an example of metaplasia. The secretory columnar epithelium may be more able to withstand the erosive ...
Further evaluation for mechanical causes of obstruction may include CT scans, MRI, or endoscopic ultrasound. [2] Several additional tests may be used to further evaluate EGJOO. [2] Further evaluation of esophageal motor function may be accomplished with functional lumen imaging probe (FLIP). [2]
Nutcracker esophagus is characterized by high-amplitude peristaltic contractions that are frequently prolonged and cause dysphagia and chest pain. [6] HLES (hypertensive lower esophageal sphincter) is a rare manometric abnormality seen among individuals with dysphagia, chest pain, gastroesophageal reflux, and hiatal hernia. [7]
Esophageal cancer usually affects the elderly. Esophageal cancers can be either squamous cell carcinoma or adenocarcinoma. Adenocarcinoma is the most prevalent in the US and is associated with patients with chronic GERD who have developed Barrett's esophagus (intestinal metaplasia of esophageal mucosa). Squamous cell carcinoma is more prevalent ...
The diagnosis is generally confirmed by esophageal manometry. [2] DES is present when more than a fifth of swallows results in distal esophageal contractions. [2] NE is present if the average strength of the contractions of the distal esophagus is greater than 180 mmHg but the contraction of the esophagus is otherwise normal. [2]
Barrett's esophagus is the dominant pre-malignant lesion of esophageal adenocarcinoma, [18] and has prevalent epigenetic alterations. [ 19 ] Esophageal squamous-cell carcinomas may occur as second primary tumors associated with head and neck cancer , due to field cancerization (i.e. a regional reaction to long-term carcinogenic exposure).
People with Barrett's esophagus (a change in the cells lining the lower esophagus) are at much higher risk, [55] and may receive regular endoscopic screening for the early signs of cancer. [56] Because the benefit of screening for adenocarcinoma in people without symptoms is unclear, [2] it is not recommended in the United States. [1]
Less than 20 eosinophils per high-power microscopic field in the distal esophagus, in the presence of other histologic features of GERD, is more consistent with GERD than EE. [46] Goblet cell intestinal metaplasia or Barrett's esophagus; Elongation of the papillae; Thinning of the squamous cell layer; Dysplasia; Carcinoma