1 Description of the disease

It is generally believed that Barrett's esophagus is a precancerous disease, as it is characterized by the presence of metaplastic epithelium of the esophageal mucosa. Often predisposing to this pathology are the decrease in the pain sensitivity of the esophagus, relaxation of the lower esophageal sphincter, etc.

When a gradual replacement of one typeepithelium to others, dysplasia is always found. Such a term characterizes a transitional situation, when a replacement has not yet happened, but the mechanism itself is launched. Specialists distinguish 2 degrees of dysplasia:

1. Medium. In the process of investigation there are modifications in the epithelium of the walls of the esophagus.
2. Heavy. The likelihood of developing Barrett's esophagus reaches 98%.

In addition, the cylindrical epithelium may be different:

• gastric fundal epithelium is localized at the bottom of the stomach;
• cardinal gastric, peculiar to the zone of the entrance to the stomach;
• epithelium with goblet cells is dangerous because of the likelihood of developing a substandard ailment.

2 The root causes of the problem

Most people have no idea what causes Barrett's esophagus. The following are some of them:

1. Reflux disease of the gastroesophageal type. A phenomenon in which the contents of the stomach periodically enter the esophagus.
2. Reflux disease of duodenogastric type. At times, the contents of the duodenum enter the stomach.
3. Reflux double type. When the two above mentioned types are combined.
4. Zollinger-Ellison Syndrome. It develops in the diagnosis of pancreatic neoplasm.

Genetic predisposition occupies an important place in the process of interviewing a patient. In the event that Barrett's esophagus was once found in one of the relatives, the chances of developing a malaise among descendants( children, grandchildren, great-grandchildren) are significantly increased. In addition, doctors are convinced that the disease can develop because of the specifics of work activity, for example, when a person constantly has to perform many inclines and ups.

It is possible to find out the exact cause only with a full examination of the patient by a specialist. Genetic predisposition can not become the basis for diagnosing during the first admission of a patient.

The main causes of pathology can be combined into the following list:

• diaphragmatic hernia;
• antral gastritis;
• poor resistance of the esophagus mucosa to harmful effects of enzymes;
• lowering the ability of the body to self-purification;
• bad habits;
• excessive body weight;
• frequent consumption of fat against a background of low consumption of antioxidants and fibrous products.

3 Symptom

Symptoms of Barrett's esophagus are the same as the manifestation of GERD.Approximately ¼ of all patients do not complain, and the rest of the symptoms are not pronounced enough brightly. A notable sign of pathology is heartburn, which is noted in all patients. Its manifestation is caused by the throwing of acidic contents from the stomach into this organ.

Symptoms of the disease include discomfort, which are exacerbated by drinking alcohol and carbonated beverages, not following a diet, physical stress. With heartburn, there may be a feeling of bitterness in the mouth.

Also the main symptoms include retrosternal pain. Usually it extends to the left side of the chest, moves to the zone between the shoulder blades and can give to the lower jaw and neck. Soreness can cause discomfort after eating, when doing inclinations and lying down.

Symptoms do not exclude the presence of a lump in the throat, loneliness.

Heartburn occurs at the conclusion of a meal( it does not have to be acute or sour food), it flows with a burning sensation in the chest, as if along the esophagus.

Symptoms such as a feeling of perspiration or soreness in the throat can develop for 30 minutes from the end of the meal. They tend to become stronger in a lying position or when tilted.

Sometimes patients describe the so-called "exhaust" - the penetration of undigested food into the esophagus from the stomach. Such "exhaust" practical burns the mucosa of the esophagus, which gives a strong discomfort to a person.

After eating, you may experience vomiting, acidic eructations, a painful sensation in the esophagus or epigastrium, and nausea. Such symptoms of the disease do not last long and appear sporadically. Some people sometimes ignore signs and compare them with ailment only when talking with a doctor.

Because of the long influence of reflux, the esophagus can be covered with erosions. Mucosal defects bleed and lead to the development of iron deficiency anemia. Accordingly, the patient has such signs as fragility of hair, dry skin, redness of the mucous tongue. There is weakness and pallor of the skin.

4 Applicable treatment for

Treatment of Barrett's esophagus mainly reduces to controlling the course of reflux disease, eliminating the symptoms of metaplasia at the histological level and following recommendations for keeping in a healthy state.

Treatment of pathology is almost similar to treatment during gastroesophageal reflux disease. To date, the production of the most effective means against the disease continues, since more logical therapy has not been determined.

Predominantly the choice of the mechanism of therapy will be due to the degree and severity of dysplasia. Often the ingestion of acidic stomach contents into the esophagus serves as the main source of the Barrett's esophagus. That is why the bulk of the drug treatment consists of inhibitors of acid formation in the stomach, a decrease in the intensity and frequency of reflux of gastric contents.

The modern drug therapy program includes the use of branded inhibitors of the proton pump, the production of hydrochloric acid in the stomach.

They are doing an excellent job of eliminating the main symptom - heartburn. As a rule, the medicines of this group are well tolerated by the patient's body. When you stop taking medication, reflux happens, but their intensity rises.

An important role is played by the safety of taking proton pump inhibitors. It rarely happens that against the background of long-term administration of such drugs polyps of the upper part of the digestive tract progressed, however often it turned out that they were benign and of small size.

Patient should remember that discontinuation of taking this group should be gradual. The rate decreases slowly, which makes it possible to reduce the likelihood of exacerbation of the symptoms of the main ailment.

Drugs from the prokinetic group help combat heartburn and a sense of rapid satiety. Of this group, the most effective are Domperidone and Metoclopramide. Take medication before meals.

Because Barrett's esophagus can be caused by different reasons, with long treatment of patients, it will be optimal to alternate different groups of medicines( in particular, if there is no effect on the mucosa side).In particular, it is necessary to replace the inhibitors mentioned earlier by means of cytoprotective and enveloping action, as they are able to protect against the negative influence of bile acids and pancreatic enzymes.

Despite the treatment, the probability of progression of adenocarcinoma can remain, even if visually from the mucosa during endoscopy there were no changes. This phenomenon is due to the fact that antiflussive therapy does not affect the extent of the areas of metaplastic epithelium in the esophagus, and therefore the probability of malignancy of the process does not decrease. Nevertheless, such therapy greatly improves the quality of life of the patient, improves his condition, and this in turn has a beneficial effect on life expectancy.

Among operational therapies, the following endoscopic methods are often used:

• endoscopic surgery;
• coagulation using argon plasma;
• system of photodynamic therapy;
• laser destruction.

Treatment with folk remedies is widely practiced with a malaise of the esophagus. As a rule, medicinal herbs, their collections and infusions, fresh vegetable juices( for example, potato and carrot) are used. Often as a home therapy, sea buckthorn oil is used, which is taken internally.

5 Nutrition and preventive measures

When prevention is not observed and even a diet for the disease, the treatment will be less productive. Diet makes it possible to correct the acidity of gastric juice and eliminate discomfort.

The power system includes hourly and fractional meals( when portions are small, and meals are often done - up to 5 times a day).The list of products that can not be eaten with ailment:

• coffee, carbonated, alcoholic beverages;
• acidic products;
• fried food;
• sweets;
• citrus fruit;
• milk and tea;
• oil, margarine, cream;Goose meat
• ;
• spices, condiments.

The diet also does not involve the inclusion of legumes, fruits and vegetables that cause gas formation in the menu. Food should be eaten only warm. With a diet can not overeat.

With the purpose of prevention, the malaise of the esophagus should be diagnosed in a timely manner, otherwise the patient's condition worsens and a malignant process may develop. To prevent the development of Barrett's esophagus will help avoiding factors that can lead to illness. You need to pay more attention to your health, do not overeat and do not eat at night, do not drink alcohol and get rid of bad habits.