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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 ...
The symptoms vary from the severity of the disorder. The most classic sign of AEN is the dark pigmentation of esophageal mucosa in an upper endoscopy, usually viewed as an ulcer or as an infectious disease. [6] Necrosis can be found mostly between the three distals of the esophagus, but stops abruptly at the gastroesophageal junction. [2]
Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus. The following are additional diseases and conditions that affect the esophagus: Achalasia [1] Acute esophageal necrosis; Barrett's esophagus; Boerhaave syndrome; Caustic injury to the esophagus; Chagas disease
Chronic inflammation caused by H. pylori infection in the stomach and GERD in the esophagus are seen as the primary instigators of metaplasia and subsequent adenocarcinoma formation. Initially, the transformed epithelium resembles the small intestine lining; in the later stages it resembles the lining of the colon .
Simple observation may be considered, [5] especially if symptoms are minimal or absent. If symptoms are severe or persistent, peroral endoscopic myotomy (POEM) may be offered. [2] Pneumatic dilation may be used for persistent symptoms in the absence of identified causes of mechanical obstruction. [2]
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]
A diagnosis of Barrett's esophagus is confirmed by a metaplastic change of the esophageal mucosa from squamous to columnar mucosa with intestinal metaplasia. Barrett's esophagus is the dominant pre-malignant lesion of esophageal adenocarcinoma , [ 18 ] and has prevalent epigenetic alterations.
If it is caused by esophagitis, in turn caused by an underlying infection, it is commonly treated by treating the infection (typically with antibiotics). In order to open the stricture, a surgeon can insert a bougie – a weighted tube used to dilate the constricted areas in the esophagus. [3] It can sometimes be treated with other medications.