Barrett’s Esophagus, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Barrett’s Esophagus, Diagnosis and Treatment and Related Diseases
Barrett’s Esophagus (BE) is a disorder in which the esophagus lining is injured by stomach acid.
Barrett’s Esophagus is described as an esophagus in which any segment of the normal distal squamous epithelial lining has been substituted by metaplastic columnar epithelium.
This is clearly seen endoscopically (>1 cm) above the gastro-esophageal junction and validated histopathologically from esophageal biopsies
People with BE have a higher risk for cancer in the area affected. Cancer is not frequent.
It is often subdivided into short-segment (less than 3 cm) or long-segment (more than 3 cm)
Causes
Barrett's esophagus occurs from chronic gastro-esophageal reflux.
The metaplastic columnar epithelium is at danger of rising stages of dysplasia resulting in invasive adenocarcinoma of the esophagus
The risk rises with longer period of time and raised frequency of gastro-esophageal symptoms.
Hiatus hernia is a danger factor and the size of the hernia is linked with the length of Barrett's esophagus
Some studies suggest a higher incidence of obesity, smoking and alcohol intake.
Risk factors for transformation to adenocarcinoma are:
1.Male gender,
2.Increasing age,
3.Extended segment (>8 cm) disease,
4.Intestinal metaplasia,
5.Duration of reflux history,
6.Early age of onset of GERD,
7.Duodeno-gastro-esophageal reflux,
8.Mucosal damage (ulceration and stricture) and
9.Family history
Symptoms
BE itself does not produce symptoms.
The acid reflux that produces Barrett’s Esophagus often results in symptoms of heartburn.
Diagnosis
The patient may require an endoscopy if GERD symptoms are severe or come back after treatment.
During the endoscopy, the doctor may obtain tissue samples from different parts of the food pipe to help diagnose the disorder.
They also help look for tissue alterations that could result in cancer.
The diagnosis of Barrett’s Esophagus needs biopsy verification of specialized intestinal metaplasia (SIM) in the esophagus
When high-grade dysplasia or cancer is discovered on surveillance endoscopy, endoscopic ultrasonography (EUS) is advised to evaluate for surgical removal.
Treatment
Treatment of GERD
The treatment should reduce acid reflux symptoms, and may keep BE from becoming worse.
The treatment may require lifestyle alterations and medicines such as:
1.Antacids after meals and at bedtime
2.Histamine H2 receptor blockers
3.Proton pump inhibitors
4.Avoiding alcohol and tobacco use
Lifestyle changes, medicines, and anti-reflux surgery may reduce symptoms of GERD.
Treatment of Barrett’s Esophagus
The doctor may advise surgery or other interventions to treat BE
Some of these procedures can eliminate the damaging tissue in the esophagus:
Photodynamic therapy (PDT) utilizes a special laser device, known as an esophageal balloon, together with a photosensitizer drug called Photofrin.
Other interventions utilize different types of high energy to damage the precancerous tissue.
Surgery to remove the abnormal lining
Esophageal cancers occurring in Barrett's esophagus determined by surveillance are often in the early stage and give an excellent prognosis.
When surveillance is regarded suitable, it should be done every 2-5 years, depending on the length of the involved segment and the presence of intestinal metaplasia.
The treatment of low-grade dysplasia is not obvious
It is advised that, after two pathologists have verified the diagnosis, surveillance endoscopy be done every six months.
High-grade dysplasia is linked with focusing on the presence of invasive adenocarcinoma in 30-40% of patients.
Esophagectomy is often done in severe dysplasia

TABLE OF CONTENT
Introduction
Chapter 1 Barrett’s Esophagus
Chapter 2 Causes
Ch

• Language: English
• Publisher: Kenneth Kee
• Release date: May 15, 2018
• ISBN: 9781370598618

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Barrett’s Esophagus,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Barrett’s Esophagus, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Barrett’s Esophagus)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Barrett’s Esophagus

Recently I have a patient who feels discomfort in the throat and has difficulty in swallowing his food.

She feels as though the food is not going down to her stomach and she has to swallow air to help the food go down (refer A Simple Guide to Aerophagia).

Once in a while she feels the food has come back up into her mouth together with some acid.

An esophageal and gastric endoscopy did not reveal any obstruction in her esophagus but there was a small ulcer in the stomach lining.

She has gastro-esophageal reflux (refer A Simple Guide to GERD) from a gastric ulcer (refer A Simple Guide to Peptic Ulcer) caused by nervous tension and irregular meals together with lower esophageal sphincter spasm.

What is