Barrett's esophagus
Introduction
Barrett's esophagus Barrett's esophagus refers to a pathological phenomenon in which the stratified squamous epithelium in the lower esophagus is replaced by a single columnar epithelium. It has no special symptoms. When it presents with esophagitis, ulcer, and cancer, it will have corresponding reflux symptoms. Barrett's epithelium is prone to cancer. basic knowledge The proportion of illness: the incidence rate is about 0.0001%-0.0002%, which belongs to precancerous lesions. Susceptible people: no specific people Mode of infection: non-infectious Complications: esophageal stricture
Cause
Barrett's esophagus
Peptic ulcer, esophagus often occurs on the basis of this lesion because the gastroesophageal reflux destroys the normal squamous epithelium and leads to the formation of a metaplastic columnar epithelium that is highly resistant to digestive juice. Narrow, intestinal metaplasia, dysplasia, until adenocarcinoma.
Prevention
Barrett's esophagus prevention
Gastroesophageal reflux is related to diet. Excessive intake of foods such as greasy, high-fat, high-protein and crude fiber is an important cause of reflux, eating greasy and hard-to-digest foods, especially long-term eating. Kinds of food, the occurrence of gastroesophageal reflux may be relatively large, in addition to greasy food, sweets are also easy to make people back to acid, heartburn, so try to avoid excessive intake.
Prevention of gastroesophageal reflux is very important, changing lifestyle is the best way to prevent pantothenic acid, heartburn, try to eat high-fat meals, chocolate, coffee, candy, sweet potatoes, potatoes, taro;
Complication
Barrett's esophagus complications Complications esophageal stricture
Can be complicated by esophageal stricture and adenocarcinoma.
Symptom
Barrett's esophageal symptoms Common symptoms Bloody sputum burns heart and sternum pain nausea and vomiting dysphagia
BE itself is asymptomatic, and its symptoms are mainly caused by gastroesophageal reflux and its complications. Most patients have GERD symptoms first, such as heartburn, reflux, difficulty swallowing, common symptoms are more common after meals and do some When the movement causes reflux, bending, increased intra-abdominal pressure or nighttime sleep may result in post-sternal burning discomfort and chest pain. Chest pain may be expressed under the xiphoid or behind the sternum. The pain may be a burning-like, acupuncture-like or Similar to angina pectoris, pain can be relieved by diet or taking antacids, and most patients with BE do not see a diagnosis of esophageal symptoms.
In general, the symptoms of BE are milder than those of BE-free gastroesophageal reflux disease, because Barrett's epithelium is more resistant to digestive acid than squamous epithelium, acid reflux, nausea is severe gastroesophageal reflux symptoms, stomach The intestinal contents can enter the oral cavity by flowing back into the esophagus. The mouth may have sour or bitter taste, bad breath, taste damage, sore throat, chronic pharyngitis, hoarseness, enamel corrosion, etc. The severity of reflux symptoms is not related to the degree of BE. Some patients have anemia or upper gastrointestinal bleeding, such as esophageal ulcers and stenosis, it is swallowing pain and corresponding obstructive symptoms, dysphagia may be caused by stenosis and columnar epithelial junction stenosis, caused by chronic esophagitis Esophageal wall fibrosis, esophageal peristalsis is weakened, acute inflammation caused by esophageal fistula or columnar epithelial carcinogenesis, adenocarcinoma caused by esophageal obstruction, and patients with severe reflux, manifested as respiratory complications, such as repeated asthma Attack, chronic bronchitis, aspiration pneumonia and pulmonary interstitial fibrosis.
Examine
Barrett's esophagus examination
1. Gastroscopic examination can be seen in the characteristic red color of the esophageal columnar epithelium, velvety tissue characteristics, and the squamous epithelium pale, smooth surface is very different, Barrett mucosa can be ring-shaped, island-shaped, tongue-shaped different appearance.
2. The application of special diagnostic techniques under endoscope can make the diagnosis of BE easier. For example, the dye endoscope with high definition or amplification is simple and safe. The dye has methylene blue (methylene blue), Lugo iodine. Liquid, toluidine blue, indigo carmine, squamous cell carcinoma, dysplasia, Barrett epithelium, gastric metaplasia and certain esophagitis do not stain, the accuracy of diagnosis of BE is 89% and specificity is 93%, indigo carmine is A blue contrasting dyeing agent makes the appearance of the BE intestinal metaplasia fluffy. Because it is a contrast agent, it is best to use high-resolution endoscopic recognition.
3. Other diagnostic techniques include photo-fluorescence endoscopy and light-scattering spectroscope. Light-scattering spectroscope can be used to detect endoscopic dysplasia. Studies have shown that this method can detect the sensitivity and specificity of atypical hyperplasia. It is 90%.
Diagnosis
Barrett's esophagus diagnosis
B is differentiated from chronic gastritis, gastric ulcer and other diseases.
