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Barrett's Oesophagus Medical Negligence
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Barrett's Oesophagus is a condition of the lower oesophagus that results from repeated exposure to the effects of stomach acid on the oesophagus. It is often diagnosed in individuals who have had a long history of GERD (gastroesophageal reflux disease). It is a serious condition of the oesophagus because many who have Barrett's oesophagus have a higher than average risk of oesophageal cancer. Those with Barrett's esophagus need repetitive endoscopies to see if they have any precancerous lesions on their oesophagus.
Barrett's oesophagus offers these signs and symptoms: difficulty swallowing larger pieces of food, frequent episodes of heartburn, pain in the chest, black or tarry stools and the vomiting of blood. Some people with Barrett's oesophagus have no symptoms at all and are at high risk of complications because they aren't screened as much as people with symptoms or known Barrett's oesophagus.
Exactly why some people with GERD get Barrett's oesophagus and why some people don't get anything more than GERD is unknown. GERD is from the back wash of acid into the oesophagus and the oesophagus can't handle the acidic contents and changes its morphology. Barrett's oesophagus comes out of the healing of the oesophagus over and over again from repetitive acid exposure. On the other hand, a few people have Barrett's oesophagus but have no reflux.
Risk factors for Barrett's oesophagus include chronic heartburn and reflux of acid into the oesophagus. It takes about 10 years before the changes of Barrett's oesophagus show up. If you are male, you are at higher risk and if you are Hispanic or white you are at a higher risk. Being an older adult puts you at higher risk, partly because they have a longer time for having GERD.
Complications of Barrett's oesophagus include a higher than average risk of oesophageal cancer. Not every person with Barrett's oesophagus get oesophageal cancer and the risk is actually small. Even so, doctors look for patients with changes in their oesophagus and follow them closely.
Doctors diagnose Barrett's oesophagus using an upper GI endoscopy that can look for changes in the oesophagus and can take a biopsy of the oesophagus to see if it shows changes suspicious for Barrett's oesophagus. The microscopic analysis of the tissue is what makes the diagnosis of Barrett's oesophagus although doctors can see in the endoscopic analysis that the tissue of Barrett's oesophagus actually looks different from regular tissue.
Doctors can grade the oesophageal tissue, including having no dysplastic changes, low grade dysplasia and high grade dysplasia, which can turn into oesophageal cancer.
There are several treatment options for Barrett's oesophagus. These include taking medications that block the H2 histamine receptor, such as Tagamet and Axid. There are medications that can block the proton pump in the stomach, lowering stomach acid, including Prilosec and Nexium. If you have dysplasia, your doctor will monitor you more closely with consecutive endoscopies to make sure you don't develop worsening dysplasia or oesophageal cancer. Barrett's oesophagus also has a chance to heal on its own and can spontaneously regress back to normal oesophageal tissue.
Those with high grade dysplasia can have part of the oesophagus removed and the stomach reattached to whatever is left. This limits the chances of Barrett's oesophagus turning into oesophageal cancer. Doctors can remove the dangerous cells just by using the endoscope. Heat can be used to remove the abnormal oesophageal tissue in a procedure called radiofrequency ablation. Photodynamic therapy is like radiofrequency ablation but uses light to damage and destroy the dysplastic tissue. Side effects of this therapy include a narrowing or stricture of the oesophagus after the procedure has had a chance to heal.