A variety of diseases are associated with several signs of disease, which are grouped under the name syndrome. One of these health conditions is known as Barrett’s syndrome or Barrett’s esophagus.
What is Barrett’s syndrome?
Reflux disease and Barrett’s syndrome go hand in hand. The human digestive system is a complicated system that consists of tissues, some of which are extremely delicate. Inflammatory processes that take place in the esophagus are therefore not uncommon, as in Barrett’s syndrome. Barrett’s syndrome is a health abnormality that occurs as a consequence of the so-called reflux disease and is treated as one of the typical complications. Not only women, but also men suffer from Barrett’s syndrome, which is usually chronic and can therefore constantly recur. The scientific name for Barrett’s syndrome has been chosen after the physician Norman Rupert Barrett.
Causes
Barrett’s syndrome can occur when reflux disease is present, resulting in damage to areas of tissue in the upper esophagus. The actual cause of Barrett’s syndrome is the influence of gastric acid flowing from the stomach back into the esophagus. In reflux disease or reflux esophagitis, the healthy DNA of the mucosal cells is affected in such a way that ulcers form, often taking a cancer-like course. Other causes underlying Barrett’s syndrome include asthmatic diseases, pregnancy, mental illness, various negative stressors and individual metabolic diseases such as diabetes mellitus. There are also some medications that promote Barrett’s syndrome. Organically caused narrowing of the gastric outlet also contributes to the disease. Clarification of which differentiated causes are involved in Barrett’s syndrome in detail is still the responsibility of medical research.
Symptoms, complaints, and signs
Among the typical symptoms of Barrett syndrome is causative heartburn. Reflux is manifested, among other things, by a burning sensation in the esophageal area, usually associated with a relatively strong feeling of pressure or heat in the nasopharynx, which can radiate from the upper abdomen to the sternum. This is accompanied by a feeling of tightness behind the breastbone. Many sufferers also experience nausea and vomiting. Hoarseness may also occur. Furthermore, Barrett’s syndrome can lead to coughing and belching in its course. A typical symptom of the syndrome is a busy voice, which becomes particularly noticeable as the disease progresses. Shortness of breath and asthma are also typical signs. Some patients also develop chronic bronchitis. Furthermore, Barrett’s syndrome can lead to difficulty swallowing and resulting weight loss. Affected individuals have a compulsion to clear their throat, which exacerbates hoarseness and can cause other symptoms such as irritation and bleeding. Esophagitis may develop, manifested by severe sore throat, mucopurulent to bloody sputum, and difficulty breathing, among other symptoms. Based on the above symptoms and complaints, Barrett’s syndrome can be differentiated from other conditions and clearly diagnosed.
Diagnosis and course
The course of Barrett’s syndrome is characterized by the growth of abnormal cell structures. In this context, it is also possible to speak of esophageal cancer, which may initially be manifested by discomfort during swallowing. Barrett’s syndrome is also manifested by permanent heartburn and later by painful abnormalities in the upper esophageal region. The pain is usually felt behind the sternum (breastbone) or the upper back area. Affected individuals also suffer from a decrease in normal body weight and can only eat thin meals with great difficulty. Patients who already suffer from reflux disease and gastric acid reflux should pay particular attention to these symptoms in order to eliminate the risk of cancer in time. For the diagnosis of Barrett’s syndrome, the information of the risk groups such as permanent belching with sour taste, vomiting with blood, black feces as well as swallowing difficulties are important.These are augmented in Barrett’s syndrome by complex medical-technical examinations such as an endoscopy of the esophagus, a so-called chromoendoscopy endoscopy with dyes) and a narrow band imaging endoscopy with blue and green colored light beams). Biopsies are also evaluated in Barrett’s syndrome.
Complications
Because different diseases are grouped together under Barrett’s syndrome, different complications occur in the process. In most cases, the patient experiences what is known as heartburn. The heartburn can greatly reduce the quality of life. Thus, a normal food intake is no longer possible, often there is a strong burning sensation in the stomach and esophagus directly after eating. Heartburn can also cause tumors and ulcers, which are life-threatening. The stomach is irritated, it is usually also no longer possible to eat sour or salty foods. This limits the patient’s daily life, often leading to social difficulties when certain events are avoided. It is not uncommon for Barrett’s syndrome to also cause shortness of breath or inflammation in the esophagus. If alcohol is ingested, Barrett’s syndrome continues to be exacerbated. Therefore, treatment is based on complete discontinuation of alcohol and other unhealthy foods and drinks. The symptoms are controlled with the help of medications. In this process, there are usually no further complications. More severe cases are treated by surgical intervention. Reflux disease can equally cause restrictions in sports activities, so that it is no longer possible to perform them without pain.
When should you go to the doctor?
Already at the first complaints and symptoms of Barrett’s syndrome, a doctor should be consulted. The disease can have a very negative impact on the patient’s health, leading to irreversible damage or even cancer. For this reason, the affected person should consult a doctor if heartburn is frequent or if reflux disease is prevalent. A medical professional should also be consulted if there is constant belching or coughing. Not infrequently, Barrett’s syndrome may also be associated with inflammation of the esophagus or shortness of breath. These complaints also indicate Barrett’s syndrome and should be examined by a doctor to avoid further complications. Difficulty swallowing or other discomfort when taking food or liquids may also indicate this syndrome and should be investigated. Similarly, Barrett’s syndrome may cause dark stools and therefore bloody bowel movements. In the first instance, Barrett’s syndrome is seen by the general practitioner. Further examinations or treatments are then performed by the internist or gastroenterologist. In acute emergencies, the patient may also go directly to a hospital.
Treatment and therapy
Treatment of Barrett’s syndrome should be initiated as early as possible. The basics of therapy represent special interventions, lifestyle changes, and permanent medical control. Over-the-counter medications are administered to counteract the heartburn. However, if the classic symptoms of Barrett’s syndrome occur, pharmaceutical substances requiring a prescription are prescribed. These are called H2 blockers and are usually taken for four to eight weeks. This treatment should be accompanied by a change in dietary composition. To inhibit the production of stomach acid, nicotine and alcohol should be reduced. Strongly spicy, hot foods also provoke a high release of gastric acid. A surgical procedure known as fundoplication can improve the closure mechanism of the esophagus, preventing stomach acid from entering the esophagus. Patients still cannot manage without medication in the majority of cases operated on.
Outlook and prognosis
Barrett’s syndrome develops in ten percent of all reflux patients. It is four times more common in men than in women because of their higher tobacco and alcohol consumption. If left untreated, the constant irritation can cause scar tissue to form and narrow the esophagus. If this condition persists for several years, there is also a risk that the pathological changes to the mucosa will develop into esophageal cancer.The higher the area of Barrett’s mucosa spreads in the esophagus, the higher the risk of cancer. To prevent this development, it is advisable to have a diagnosed Barrett’s syndrome closely monitored by a gastroenterologist. He will monitor the development of the disease with the help of endoscopic progress controls and, if necessary, suggest suitable therapy methods. As a preventive measure, the patient should avoid alcohol, nicotine, spicy and acid-forming foods, and eat a high-protein diet. It is recommended to reduce existing excess weight and avoid stress as much as possible. To reduce stomach acid, the doctor will prescribe medications such as proton pump inhibitors or H2 blockers. With regular medical care, there is a good chance of a relatively symptom-free life with the prognosis that tumor disease can be prevented in most cases.
Prevention
Few clues are available in the prophylaxis of Barrett’s syndrome. These are largely aimed at optimizing unfavorable external factors in terms of dietary composition and avoiding nicotine and alcohol. Reducing excess weight is also recommended as a preventive measure against Barrett’s syndrome. Elevating the upper body when lying down can also prevent gastric acid reflux and the associated Barrett’s syndrome.
Follow-up
Barrett’s syndrome requires lifelong medical follow-up. The consensus among physicians is that endoscopic monitoring is required at regular intervals. The condition of the esophagus should thereby be surveyed. The rhythm should increase especially if a tissue sample certifies a precancerous condition. In this way, complications can be prevented. Acute intervention by surgery is possible. In addition, patients should follow some everyday tips. They will be informed about these by the attending physician. Adherence to them is advisable, because only then will the typical symptoms disappear. The main focus is on a balanced and healthy diet. Foods and drinks that contain a lot of acid are considered harmful. Foods of particular spiciness should also be avoided because it causes irritation. A half-hour walk is recommended after each main meal. Patients should maintain their normal weight or reduce excess fat. It has been scientifically proven that alcohol and nicotine trigger symptoms. Wearing overly tight clothing is also considered harmful. In many cases, lying with the upper body elevated during sleep helps to calm the patient at night. It is not uncommon for doctors to prescribe medications that reduce acidity. In some cases, they are even available without a prescription and can be taken as prescribed.
Here’s what you can do yourself
If Barrett’s syndrome is suspected, the first thing to do is talk to a medical professional. Together with the doctor, a number of self-help measures can be devised that can often reverse the esophageal condition. After diagnosis, the first thing recommended is a change in lifestyle. A healthy and balanced diet is the most effective remedy for the syndrome. In addition, digestive walks should be incorporated into the daily routine. Patients who suffer from obesity should change this by exercising and changing their diet. Stimulants such as alcohol, nicotine or coffee should be avoided after a diagnosis of Barrett’s esophagus. So should foods and drinks that contain a lot of acid, are particularly spicy, or might otherwise irritate the esophagus. A detailed diet plan should be developed in collaboration with the appropriate physician. To reduce acute discomfort, sufferers should sleep with their upper body elevated at night. Barret’s esophagus patients should also avoid wearing overly tight clothing and always keep the throat warm to avoid complications from colds. Further tips on the treatment of Barrett’s syndrome are provided by information brochures and discussions with other sufferers.