Barrett's esophagus is a pathological change in the structural system of the epithelial layer of the esophageal mucosa, characterized by the appearance of atypical epithelial cells in the form of a cylinder. This is a very complex disease that is a consequence of a number of complications from gastroesophageal reflux disease (GERD). This condition can lead to irreversible damage to the esophageal mucosa and provoke malignant neoplasms and tumors. Medical science notes that patients with this diagnosis constitute a risk group for cancer of the gastrointestinal tract.
Causes
Barrett's esophagus is a result of the invasion of other foreign epithelial cells from the stomach into the esophageal mucosa. This often occurs due to various diseases of the gastrointestinal tract – gastritis, pancreatitis, peptic ulcer disease, cholelithiasis, etc.
Among the direct causes of Barrett's esophagus, medical science identifies the following:
- Hiatal hernia;
- Weakness of the esophageal sphincter;
- Stenosis of the gastro-duodenal sphincter;
- Systematic overeating, improper nutrition;
- Alcohol, smoking;
- Long-term use of medications affecting the mucosa;
- Previous surgeries on the gastrointestinal tract.
Diagnosis of Barrett's Esophagus in Israel
The symptoms of Barrett's esophagus are similar to the external and structural manifestations of reflux disease. The patient's condition depends on the degree of esophageal compromise and the level of hydrochloric acid in the gastric juice.
The most common and characteristic symptoms of Barrett's esophagus include the following signs:
- Persistent heartburn;
- Frequent belching, air regurgitation;
- Bitter taste in the mouth;
- Nausea, frequent urges to vomit;
- Insufficient passage of food through the esophagus, swallowing dysfunction;
- Chest pain.
Typically, to diagnose Barrett's esophagus in a patient, specialists first conduct examinations for reflux disease. For a more detailed analysis and a clearly defined diagnosis, the patient needs to undergo a series of laboratory and endoscopic examinations.
At Ichilov Medical Center, the list of diagnostic services includes the following procedures:
- Comprehensive blood analysis;
- Esophagochromoscopy (using special contrast agents that stain problematic cells and areas of damage);
- Computed tomography;
- Gastroscopy under sedation (with or without biopsy);
- MRI;
- Fibrogastroscopy (using a special device equipped with lighting and surgical instruments, detects destruction in the lower part of the esophagus);
- Radioisotope examination method (studies the level of radioactive substances in the esophageal mucosa).
Treatment of Barrett's Esophagus in Israel
Typically, the therapeutic course applied for Barrett's esophagus includes many procedures that are used in the treatment of reflux disease. However, it is important to note that to neutralize the activity of hydrochloric acid in the case of Barrett's esophagus, more effective tools are needed. For this purpose, doctors at Ichilov Medical Center have developed a special medication course that includes such types of drugs as antacids, proton pump inhibitors, alginates, and prokinetics. Recently, treatments such as laser therapy and photodynamic therapy have proven to be very effective. In more severe forms of the disease that require maximum effect, surgical intervention is undoubtedly used.
At Ichilov Medical Center, the following types of surgical interventions are available:
- Laparoscopic fundoplication (using small openings to reduce acid reflux from the stomach);
- Radiofrequency ablation (using radio waves and thermal energy to destroy pathogenic cells);
- Esophageal resection (in cases of irreversible changes and precancerous conditions).