Ibiza Sun - Medical Surgery

Medical Surgery

Barrett’s Oesophagus
One of the most common digestive symptoms people complain about is acid reflux or heartburn causing oesophagitis. We probably all recognise the burning feeling that arises from behind the sternum, sometimes rising up into the oesophagus or even the mouth. This symptom is widespread, and can be a sign that we have eaten or drank too much rich, spicy food or simply even a particular food that ‘doesn’t agree with us’. One of the problems with this symptom, if it persists, is that it can lead to further complications. One of these potential complications is Barrett’s Oesophagus.
The lining of the stomach is designed to withstand an acidic environment; however the oesophagus, the tube that connects the mouth to the stomach is not. Repeated acidic exposure damages the epithelial cells that line the lower end of the oesophagus. This means that the shape and the function of these cells change slightly. They change from the ‘normal’ whitish round cells to red inflamed columnar shaped cells. These changed cells are termed dysplasic, that is a cell that is abnormal in shape with respect to what it should be but is not yet cancerous. However these cells do have a higher likelihood of transforming into cancerous cells than a normal cell therefore they are sometimes called precancerous cells (they can also appear in other parts of the body such as the cervix).
Barrett’s Oesophagus is diagnosed by endoscopy and biopsy, as confirmation of the changes in the cells is central to diagnosis. Endoscopy can be carried out by traditional method, i.e. a fibre optic camera which is quite rigid and the patient needs to be sedated. A newer technique uses a capsule (the size of a big pill) on ‘cord’ that the conscious patient swallows. The capsule sits at the lower end of the oesophagus and dissolves leaving a small sponge. When this sponge is retrieved it brings with it some cells which are then analysed.
Other symptoms of acid reflux which people with Barrett’s Oesophagus may experience include; bloating, nausea, abdominal or epigastric pain and pain when swallowing. Many of these symptoms are caused by a malfunctioning cardiac sphincter that doesn’t close properly allowing stomach contents to rise into the oesophagus. Because of these cellular changes people who have Barrett’s Oesophagus have an increased risk of developing oesophageal cancer. Not everyone with Barrett’s Oesophagus will go on to develop cancerous cells, the majority won’t, however vigilance with regular endoscopy is advised to monitor the cells. The lifetime risk of dysplasic cells developing into cancerous cells is 1 in 20 for men and 1 in 33 for women. Pregnancy and having a hiatus hernia both increase risk as they both influence how the cardiac sphincter function.
Treatment includes an antacid or proton pump inhibitors, which stem acid production in the stomach, reduces both the acid produced and risk of any regurgitated stomach contents damaging the oesophagus lining. In persistent cases an operation to tighten the sphincter may be useful. There are also steps we can take ourselves such as weight control and cessation of smoking both of which increase risk. Controlling diet includes eating less fried, spicy food, less caffeine and alcohol and chocolate can also help. New treatments include radio frequency ablation treatment, which ‘burns off’ the Barrett’s cells, removing the risk of them progressing to cancerous cells.

If you would like me to address any health related topic please get in touch via The Ibiza Sun or at ibizanursemassage@yahoo.com.

Kevin, writer of this column works as a nurse and sports massage therapist and can be contacted on tel. 634527800 or email ibizanursemassage@yahoo.com. Good health to you all.