Abstract
Barrett's esophagus a is metaplasia of normal squamous cells that line the lower part of the esophagus and carries a major risk for adenocarcinoma of esophagus. In Asian population, the prevalence of Barrett's esophagus and adenocarcinoma are less common than in Western countries but has been increasing. This is a hospital based descriptive study comprising of 120 consecutive patients with symptoms of gastroesophagial reflux disease belonging to both sexes of any age group. The diagnosis of gastroesophagial reflux disease was based on the symptoms like heart burn and regurgitation. Upper gastrointestinal endoscopy was done in all the patients. Four quadrant biopsies were taken from the esophagogastric junction in suspected case of Barrett's esophagus. The diagnosis of Barrett's esophagus was confirmed histopathologically. There were 44.2% males and 55.8% females, age ranging from 22 to 85 years mean being 44.33+13.37. Of them, gastroesophagial reflux disease was mild in 54.16%, moderate in 21.16% and severe in 16.66%. Upper Gastrointestinal endoscopy revealed non erosive gastroesophagial reflux disease in 50%, erosive in 45%, hiatal hernias in 5% and Barrett's esophagus in 1.6%. Both patients with Barrett's esophagus were elderly and had short segment (<3cm) involvement with no evidence of dysplasia or adenocarcinoma histopathologically. Endoscopic surveillance with detailed inspection and systematic biopsies is recommended for most patients with Barrett's esophagus. Esophageal carcinoma if detected should be treated at the earliest.
Highlights
Barrett’s esophagus is the designation for replacement of the normal squamous epithelium of the distal esophagus by metaplastic intestinal columnar glandular epithelium
Norman R Barrett first described this entity in 1950.1 The metaplastic epithelium progress through a multi step process to low grade dysplasia, high grade dysplasia and to adenocarcinoma though the risk is only 0.5% per patient year.[2]
This study aims at symptomatology together with invasive upper gastrointestinal endoscopy and biopsy in patients with Gastroesophageal Reflux Disease (GERD) for the identification of Barrett’s esophagus
Summary
Barrett’s esophagus is the designation for replacement of the normal squamous epithelium of the distal esophagus by metaplastic intestinal columnar glandular epithelium. Norman R Barrett first described this entity in 1950.1 The metaplastic epithelium progress through a multi step process to low grade dysplasia, high grade dysplasia and to adenocarcinoma though the risk is only 0.5% per patient year.[2] The combination of esophageal endoscopy indentifying this mucosal change with a proper knowledge of the gastroesophageal junction and confirming the intestinal metaplasia by biopsy is currently the primary modality for routine disease surveillance. There are limited data from Nepal regarding study of GERD and correlation with Barrett’s esophagus. This study aims at symptomatology together with invasive upper gastrointestinal endoscopy and biopsy in patients with GERD for the identification of Barrett’s esophagus. In Asian population, the prevalence of Barrett’s esophagus and adenocarcinoma are less common than in Western countries but has been increasing
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