Barrett's Esophagus

WHAT YOU SHOULD KNOW:

• Barrett esophagus, or BE, is also called columnar-lined esophagus. This is a type of precancerous disease that affects and damages the esophagus (food pipe). Precancerous means that it may lead to cancer (tumor). With Barrett esophagus, normal cells lining the esophagus may have had an injury that caused inflammation (swelling) and damage. When the damaged areas heal, cells may undergo dysplasia. Dysplasia is where abnormal cells grow and divide without order, and replace the normal cells. This process may later lead to esophagus cancer. A Barrett esophagus may either have a long or short segment (piece) depending on the length of abnormal tissues.
  
  
• The most common symptom is heartburn, which is a burning pain in the chest. This usually occurs after meals and may spread to your neck, jaw, or shoulder. You may also have pain or trouble while swallowing, frequent choking or coughing, vomiting (throwing up), or weight loss. Barrett esophagus is diagnosed by endoscopy and biopsy, and is graded based on the amount of dysplasia that is present. Treatment may include medicines and surgery. You may also need to make diet and lifestyle changes to treat Barrett esophagus. With treatment, such as medicine and surgery, your symptoms may be relieved, and cancer of the esophagus prevented.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• Treatment for Barrett esophagus may cause unwanted side effects. Your esophagus, stomach, blood vessels, or nerves may get injured while having surgery. You may have trouble breathing, an infection, or bleeding after surgery. You may also feel bloated (too full) after meals or have scars that can narrow the esophagus. Even after having surgery or other therapies, abnormal cells may grow again and cause further problems. Your chances of keeping Barrett esophagus from becoming cancer are better if you are treated. If left untreated, it can become a full-blown esophageal cancer and spread to other parts of your body. Once cancer spreads, it becomes more difficult to treat and other serious medical problems can develop. Call your caregiver if you are worried or have questions about your condition, care, or medicines.
  
  

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Soft food diet: You may be allowed to eat soft foods. Some examples are applesauce, baby food, bananas, cooked cereal, cottage cheese, eggs, gelatin, pudding, and yogurt.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Medicines: You may need any of the following:

• Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up).
  
  
• Histamine type-2 receptor blocker: This is also called an H2-blocker. This medicine stops acid from being produced in the stomach.
  
  
• Proton pump inhibitor: This is also called a PPI. This medicine blocks acid from being made in the stomach.

Tests: You may have any of the following:

• Blood and stool tests: Samples of your blood or stool may be collected and sent to a lab for tests.
  
  
• Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.
  
  
• Esophageal manometry: This test measures the pressure in the esophagus and the stomach.
  
  
• Esophageal pH monitoring: A small probe is placed inside the esophagus to check the pH of the stomach and esophagus. The pH measures how much acid is in your esophagus and stomach. It can also measure the amount of acid and bile that reflux (back up) into the esophagus.

Treatment options: The following may be done when medicines cannot control your symptoms or other problems, such as high-grade dysplasia, are present.

• Surgery: Your caregiver may suggest surgery depending on the type of Barrett esophagus you have. Surgeries may include the following:
  
  
  • Fundoplication: Fundoplication is a surgery that wraps the upper part of the stomach around the esophageal sphincter to strengthen it. A sphincter is a ring-like muscle that opens and closes an opening in your body. Strengthening the sphincter may help to prevent reflux.
    
    
  • Resection or esophagectomy: Your caregiver may remove a part of or the entire esophagus.
  
  
• Other treatments: Ask your caregiver about the following treatment options for Barrett esophagus.
  
  
  • Ablation: Barrett esophagus may be treated by using a special thermal (heat) ultrasound or freezing ablation treatment.
    
    
  • Photodynamic therapy: Lasers, in combination with medicines that become active when exposed to light, are used to destroy abnormal cells.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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