Barretts Oesophagus?

Question

Could anyone please tell me how you can tell when Barretts Oesophagus has turned into a cancerous state?eg are there any changes with the symptoms of BS?Thanks

Answer 1

Regular endoscopic surveillance. Don't rely on symptoms alone.

Answer 2

Barrett's oesophagus is a condition which affects the lower oesophagus. (It is named after the doctor who first described it.) The cells that line the oesophagus in the affected area become changed.

The cells of the inner lining (epithelium) of normal oesophagus are pinkish-white, flat cells (squamous cells). The cells of the inner lining of the area affected by Barrett's oesophagus are tall, red cells (columnar cells). The columnar cells are similar to the cells that line the stomach.

The changed cells at the lower end of the oesophagus are not cancerous. However, these cells have an increased risk (compared to normal oesophagus cells) of turning cancerous in time. The risk is small. About 1 or 2 people in 100 with Barrett's oesophagus develop cancer of the oesophagus at some stage in their life.

Heartburn is the main symptom. It is a burning feeling that rises from the upper abdomen or lower chest up towards the neck. (It is confusing as it has nothing to do with the heart!). Other common symptoms include: pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, and a burning pain when you swallow hot drinks. Like heartburn, these symptoms tend to come and go, and tend to be worse after a meal.

There are various degrees of dysplasia from low-grade dysplasia to high-grade (severe) dysplasia. Cells that are classed as high-grade dysplasia have a high risk of turning cancerous at some point in the future.

Barrett's oesophagus is not a cancerous condition, but over a long period of time it can occasionally lead to cancer developing in the lower part of the oesophagus. A cancer happens when cells in the affected area continue to grow and reproduce and become increasingly abnormal. Approximately 1-2 out of every 200 people in the UK have Barrett's oesophagus; however, very few people with this condition go on to develop cancer (about 1 in 100 each year).

Answer 3

only about 1 or 2 people in 100 with Barrett's oesophagus develop cancer and the main symptoms are heartburn, stomach and chest pain and bloatiness.

Answer 4

You can get rid of acid reflux and heartburn with this natural method http://acidreflux-cure.info
Usually, heartburnThe most common symptom of acid reflux disease (also known as gastroespohageal reflux disease, or GERD). Heartburn feels like a burning pain in the center of the chest. It is caused by acid from the stomach backing up into the esophagus. is a symptom of acid reflux disease (GERD) Also known as Gastroesophageal Reflux Disease (GERD). Describes the condition of backflow of stomach acid into the esophagus which frequently happens when the lower esophageal sphincter (LES) relaxes more often than it should and/or at inappropriate times. The symptoms of acid reflux disease typically occur on 2 or more days a week.. And if you suffer from persistent heartburn on two or more days a week—and you’ve treated it and changed your diet—it could be due to acid refluxBackflow of stomach acid into the esophagus. Acid reflux frequently happens when the lower esophageal sphincter (LES) relaxes more often than it should and/or at inappropriate times. This allows harsh stomach juices to back up into the esophagus. disease. But only your doctor can tell you if these are signs of acid reflux disease.

Answer 5

So..
I was a acid reflux sufferer. I followed this natural program http://www.goobypls.com/r/rd.asp?gid=568

I feel much better now. Now no more hearthburns!
Cheers ;)

Answer 6

I think they can tell what stage of malformation the cells are in.

Answer 7

http://www.countrydoctor.co.uk/education/education%20-%20Barretts%20oesophagus.htm

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Barretts Oesophagus and cancer

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Press release
MANY SPECIALISTS ARE UNAWARE OF PATIENTS’ RISK OF DEVELOPING THE PRE-CANCEROUS CONDITION – BARRETTS’ OESOPHAGUS


March 21, 2002 – British Society of Gastroenterology (BSG), Birmingham.

Eighty three per cent of physicians surveyed at the BSG conference are unaware1 of the proportion of patients with chronic reflux disease (10-15%) who may go on to develop Barrett’s oesophagus - a precursor lesion for oesophageal adenocarcinoma.2 For those patients diagnosed with Barrett’s oesophagus, there is a 40-fold higher risk of developing this form of oesophageal cancer.2 While doctors recognise that the incidence of this type of cancer is the most rapidly rising of any over the past 30 years2, the results of the opinion poll demonstrate that the majority perceive the risk of their reflux disease patients developing Barrett’s oesophagus as low.1

Evidence suggests that it is more likely that an oesophagus damaged by acid reflux may progress, over time, towards more serious complications, such as reflux oesophagitis and Barrett’s oesophagus.3 Consequently, the healing of the oesophagus should be the primary goal for physicians treating patients at risk of complications from reflux disease. However, it is also important to ensure that healing is maintained, as a recent study suggests that as many as 80 per cent of patients experience symptomatic recurrences of their erosive oesophagitis within six months, if inadequate maintenance therapy is prescribed. 4

Clinical data presented yesterday at the BSG demonstrate that Nexium (esomeprazole) 20mg once daily maintains significantly more reflux oesophagitis patients in remission than the lowest licensed dose of lansoprazole 15mg once daily at six months (p<0.0001). 5 The study, conducted by Lauritsen et al, is the first to compare esomeprazole 20mg to lansoprazole 15mg. It also shows that esomeprazole is significantly more effective than lansoprazole (LA grades B, C, D; p<0.05 for each comparison) in the long-term maintenance of reflux oesophagitis in patients with moderate to severe disease at six months, with an increasing difference as the severity of the disease increases.6

Dr Howard Smart, a Consultant Gastroenterologist at the Royal Liverpool University Hospital, believes that doctors need to provide patients with a treatment that will maintain their symptom control effectively over the long term, to avoid further damage or possible complications, and to keep patients from having to make multiple presentations to the surgery. He says, “I want my patients to be able to live normal lives, without fear of breakthrough symptoms that mean returning to the surgery for new medication. The Lauritsen study provides more evidence to suggest that esomeprazole is a good choice - first for healing, and now for maintenance.”

The Lauritsen study also found that esomeprazole 20mg once daily maintains significantly more reflux oesophagitis patients free from heartburn, acid regurgitation and epigastric pain than lansoprazole 15mg once daily at six months (p<0.05 for each comparison).5,6 Together with information from another study, these data may have positive implications on the patient’s quality of life, as 50 per cent of sufferers say that they would alter or even avoid basic daily activities, such as eating and drinking, because of their symptoms.7

These clinical data should be of particular value to the primary care physician, who can often face difficulty when accurately diagnosing the degree of reflux disease, as almost one third of GPs do not have open access to endoscopy services.8 There is a poor correlation between the severity of reflux disease and the presence and severity of symptoms3, and many GPs have to prescribe an effective treatment for reflux disease without confirmation of the clinical diagnosis and severity of the condition.

In the Lauritsen study esomeprazole 20mg is compared with the lowest licensed dose of lansoprazole 15mg for maintenance therapy in patients with healed reflux oesophagitis


Esomeprazole 20mg once daily was compared with lansoprazole 15mg once daily for the prevention of recurrence of reflux oesophagitis in 1,236 patients with endoscopically verified reflux oesophagitis (LA classification) after initial healing with 4-8 weeks of esomeprazole 40mg once daily5.
Esomeprazole 20mg once daily maintained a significantly higher proportion of patients in remission than lansoprazole 15mg once daily over the 6 month course of treatment (p<0.0001, ITT analysis) 5.
After 6 months treatment, 83 per cent of esomeprazole recipients were in remission compared with 74 per cent of lansoprazole recipients5.
Significantly more patients were free from heartburn in the esomeprazole group compared to the lansoprazole group at 1, 3 and 6 months (p<0.05) 5. Significant differences at 6 months between esomeprazole 20mg once daily and lansoprazole 15mg once daily were also observed for freedom of epigastric pain and acid regurgitation (p<0.05 and p<0.001, respectively) 5.

Reflux Disease
Reflux disease is a potentially debilitating condition affecting approximately one in 10 of the population9, although a recent public survey suggests that this number may be as large as almost one in four people10. In fact, nearly seven out of ten specialists who took part in the BSG opinion poll, said that they had suffered heartburn or reflux disease.1 Reflux oesophagitis (inflammation of the lining of the oesophagus) is a complication of reflux disease and occurs when the oesophagus is repeatedly exposed to acid from the stomach.

Barrett’s oesophagus
Barrett’s oesophagus is believed to be caused by a disordered repair response to acid reflux damage in the oesophageal epithelium2, wherein the squamous cells lining the oesophagus adapt over time to become more like the cells found in the lining of stomach.

AstraZeneca
AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. The company is one of the top five pharmaceutical companies in the world, with leading positions in sales of gastrointestinal, oncology, anaesthesia (including pain management), cardiovascular, central nervous system (CNS) and respiratory products.

References:

Data on file. AstraZeneca NEX/072/MAR2002.

Fennerty B. Update on Barrett’s Oesophagus. Presentation at the Digestive Diseases Week, Atlanta, Georgia USA, May 2001.

Green JRB. Is there such an entity as mild oesophagitis? Eur J Clin Res 1993; 4: 29-34.

Sontag SJ. Rolling review: gastro-oesophageal reflux disease. Aliment Pharmacol Ther 1993; 7: 293-312.

Lauritsen K, Junghard O, Eklund S. Esomeprazole 20mg compared with lansoprazole 15mg for maintenance therapy in patients with healed reflux oesophagitis. Abstract and poster presented at the World Congress of Gastroenterology; 2002 February 28; Bangkok, Thailand.

Data on file AstraZeneca Nex/063/Dec 2001.

Gut reactions. Pan European Perspective on GERD. Research conducted by Research International Ltd. Supported by an educational grant from AstraZeneca.

A Burning Question. Therapeutic options in reflux disease. Doctor 2001; 13 December 2001 (Suppl).

Petersen H. The prevalence of gastro-oesophageal reflux disease. Scand J Gastroenterol 1995; 30(suppl. 211):5-6.