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Barrett's oesophagus, Allison-Johnstone anomaly, columnar epithelium lined lower oesophagus (CELLO) Endoscopic image of Barrett's esophagus, which is the area of dark reddish-brown mucosa at the base of the esophagus. (Biopsies showed intestinal metaplasia.) Specialty: Gastroenterology General surgery: Symptoms: Nausea
Although H. pylori infection can cause gastrointestinal metaplasia, its eradication does not reverse the process. [1] Bile reflux is an additional pathogenic factor in gastrointestinal metaplasia that can continuously irritate the gastric mucosa. Bile acids in refluxed fluid are widely reported to be associated with gastrointesinal metaplasia ...
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. [19]
Metaplasia; Micrograph of a gastro-esophageal junction with pancreatic acinar metaplasia. The esophageal mucosa (stratified squamous epithelium) is seen on the right. The gastric mucosa (simple columnar epithelium) is seen on the left. The metaplastic epithelium is at the junction (center of image) and has an intensely eosinophilic (bright pink ...
The barrier formed by the intestinal epithelium separates the external environment (the contents of the intestinal lumen) from the body [15] and is the most extensive and important mucosal surface of body. [18] The intestinal epithelium serves several crucial functions, exhibiting both innate and adaptive immune features.
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 in Asia and is associated with tobacco smoking and alcohol use.
Barrett's esophagus – intestinal metaplasia (changes of the epithelial cells from squamous to intestinal columnar epithelium) of the distal esophagus [20] Esophageal adenocarcinoma – a form of cancer [17] GERD sometimes causes injury of the larynx (LPR). [21] [22] Other complications can include aspiration pneumonia. [23]
Owing to the causal relationship between H. pylori infection and gastric MALT lymphoma, identification of the infection is imperative. Histological examination of GI biopsies yields a sensitivity of 95% with five biopsies, [7] but these should be from sites uninvolved by lymphoma and the identification of the organism may be compromised by areas of extensive intestinal metaplasia.