Saturday, January 22, 2011

Barrett's esophagus

Barrett's esophagus Barrett's esophagus is characterized by precancerous changes of the esophageal mucosa due to repeated injuries in the mid inferioara.Cauza acid most frequent reflux disease is esofagiana.Exista a number of risk factors for Barrett esophagus: -The recent installation of reflux symptoms Long-time evolution of symptoms Reflux-simprome this night. Patients most at risk of developing this disorder are male Caucasians over 50 years with a history of retrosternal heartburn. Symptoms of Barrett's esophagus are similar to those of gastro-esofagian.Acestea include retrosternal burning and acid regurgitation. Some people have and swallowing difficult symptoms require immediate medical intervention. The only form of biopsy to confirm the diagnosis by endoscopy. Treatment is similar to that of reflux.Acesta disease include lifestyle changes, stopping smoking, greasy dishes, spicy foods, carbonated drinks, chocolate, coffee and alcohol. Medications include antacids: antihistamines, protective agents, proton pump inhibitors. Barrett's esophagus is a premalignant condition that can lead to esophageal cancer. It dezvoltaa by modifying specific cells in specific cell esophageal mucosal lining of the stomach, the protection factor inpotriva acidity. Patients with Barrett's esophagus should undergo repeated screening exams to detect cancer in its early stages. One of the treatments tested is transformed premalignant laser ablation area.
Pathogenesis Defines this type Barrett metaplasia in distal esophagus, less than 1 cm from the edge of the proximal gastric folds on the greater curvature of the cylindrical type epithelium specialized caliciform attested by the presence of cells. The most accepted theory to explain the appearance of type Barrett's metaplasia, such as the one that assumes that aggression produces acid lesions of chronic esophageal squamous epithelium, which is ongoing descuameaza and replaced with cylindrical type gastric epithelium, more resistant to acid.Importanta this syndrome lies in more than 100 times the risk of developing esophageal cancer.

Signs and symptoms People with Barrett's esophagus have no symptoms, they are those of gastro-esophageal reflux disease: Heartburn, retrosternal Food-bolus feeling stuck in throat Difficult or painful swallowing, Cough, shortness of breath-by aspiration pneumonia, asthma, bronchitis Haematemesis, bleeding-mouth protrudes -Vomiting and nausea -Anemia, weight loss. These symptoms occur mostly at night, when the patient is lying, after certain types of foods and drinks, or medical conditions: pregnancy, obesity, gastric diabet.In gastroparesis symptoms are more severe Barrett's esophagus.

Diagnosis Diagnosis of Barrett's esophagus is the most reliable biopsy, and examination by endoscopy and endoscopic inumohistochimic.Metaplazia can be observed directly or methylene blue staining of the Z-line transition zone between the esophagus and the stomach epithelium. H. pylori infection is a risk factor and its detection tests are important: antru biopsy or gastric fundus, the urea breath test and serological measurement.

Treatment Medication is the same as for gastro-esophageal reflux disease: -Antacids: antihistaminiceH2-drugs that bind to preventing the action of histamine H2 receptor and release of acid: cimetidine, famotidine, ranitidine Proton-pump inhibitors: omeprazole, pantoprazole, lansoprazole -Action drugs ACTA protezeaza mucosa of forming a protective blanket on the surface, they contain a form of rubber and Al, Mg, Ca The preparations are constipating, and those with Mg diarrheal examples sucralfate Ca carbonate Surgical treatment includes the following techniques, laparoscopic or endoscopic made: -Fundoplication in GERD-base surgery, the procedure involves suturing the gastric fundus (the part closest to the junction with the esophagus), around the distal esophagus and lower sphincter, reducing the diameter such that he is incompetent SEI Z-resection line, the junction between the esophagus and the gastric mucosa, metaplasia: Laser or termochirurgie

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