User:Mr. Ibrahem/Barrett esophagus

Barrett esophagus (BE) is an abnormal change of the cells lining the lower portion of the esophagus from squamous epithelium to columnar epithelium. Though it does not result in symptoms itself, associated symptoms may include heartburn, acid reflux, and trouble swallowing. It is precancerous condition in which less than 5% develop esophageal adenocarcinoma.

The underlying mechanism is thought to be adaptation to long term acid exposure due to gastroesophageal reflux disease (GERD). Some cases may also run in families. Risk factors include hiatal hernia, pregnancy, obesity, asthma, diabetes, and peptic ulcer disease. It is classified into four types: nondysplastic, low-grade dysplasia, high-grade dysplasia, and invasive adenocarcinoma. Testing for the condition is recommended in males who have symptoms for more than five years along with other risk factors. Diagnosis is confirmed by seeing the characteristic appearance on endoscopy and tissue biopsy.

Treatment is generally with a proton pump inhibitor with further efforts depending on the type. When no dysplasia is present surveillance is recommended every 3 to 5 years. For low-grade dysplasia surveillance every 6 to 12 months or endoscopic ablation is recommended. For high-grade dysplasia treatment is with resection of the involve mucosa followed by ablation. If the mucosa looks normal but the biopsy is concerning radiofrequency ablation is recommended. If cancer is present surgery may be recommended.

About 1.5% of the general population and 10% of people with GERD are effected. The average age at diagnosis is 55. Males are effected more often than females. The condition may have been initially described in 1879 by Heinrich Quinke and 1906 by Wilder Tileston. Further descriptions occurred in 1950 by the surgeon Norman Barrett, after who it is named.