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Barrett's Syndrome



Barrett's Syndrome Definition


Barrett's syndrome, also known as “Barrett's esophagus”, “CELLO” or simply “Barrett's” is a condition wherein patients experience an abnormal change in the cells of the lower part of the esophagus. Named after Dr. Norman Barrett, a British surgeon from St. Thomas Hospital that described the condition in 1957, Barrett's syndrome is believed to be caused by reflux esophagitis or damage from exposure to chronic acid. Barrett's syndrome occurs in 10% of patients seeking medical attention for heartburn. In addition, Barrett's is considered a premalignant condition, which is associated with a great risk of esophageal cancer.


Barrett's Syndrome Symptoms and Signs


GERD (gastroesophageal reflux disease) causes Barrett's syndrome. However, not all GERD patients develop this disease. Studies show that there is a relationship between chronic heartburn and the development of Barrett's syndrome. Sometimes, patients with Barrett's may show no signs of heartburn at all. These patients could have a damaged esophagus due to swallowing an acidic substance like lye. Warning signs that a person has Barrett's esophagus include vomiting blood, trouble swallowing, frequent, painful and longstanding heartburn, pain under the breastbone and sudden weight loss because eating and digesting food can be painful.


Barrett's Syndrome Treatment


When Barrett's syndrome is confirmed, routine biopsy and endoscopy every 12 months is needed. This routine should also be complemented with proton pump inhibitor drugs to control the underlying reflux. Proton pump inhibitors have not been proven to prevent cancer of the esophagus. However, laser treatments are used in serious cases of dysplasia while “overt malignancy” need systemic chemotherapy, radiation therapy or even surgery. A new operation called “Nissen fundoplication” works by reducing the reflux of acid from the patient's stomach to his esophagus. In addition, NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin have shown evidence in preventing esophageal cancer in patients with Barrett's syndrome.


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