| disease | Barrett's Syndrome |
| alias | Chronic Peptic Ulcer, Barrettulcer, Barrett's Syndrome, Barrett Syndrome, Esophagitis Syndrome |
Barrett Syndrome refers to the replacement of the lower esophageal mucosa by gastric columnar epithelium. It is also known as Barrett ulcer, chronic peptic ulcer, and esophagitis syndrome. First described by Barrett in 1950, it is hence called Barrett Syndrome. This condition can be congenital but often occurs secondary to reflux esophagitis, leading to esophagitis and ulcers on the basis of gastroesophageal reflux.
bubble_chart Pathological Changes
The acid-intolerant squamous epithelium is damaged, while the acid-resistant columnar epithelium regenerates and gradually spreads upward to involve the lower esophagus. Ulcers may penetrate the esophageal wall, causing fibrosis of mediastinal tissue and lymphadenitis. If blood vessels are damaged, bleeding occurs, and the mediastinum and pleura may develop purulent sexually transmitted disease changes. Microscopic examination reveals abnormalities and hyperplasia of atypical columnar epithelium in the mucosal lining.
bubble_chart Clinical Manifestations
This condition is commonly seen in middle-aged or elderly individuals. The main symptoms include recurrent substernal pain and a burning sensation, particularly after consuming cold, hot, or acidic foods, or when lying down. The pain may radiate to the neck, shoulder blades, or both arms. In advanced stages, symptoms such as difficulty swallowing, vomiting, hematemesis, and melena may occur. Additionally, complications such as ulcer perforation or bleeding may arise.
bubble_chart Auxiliary Examination
1. X-ray examination reveals a solitary crater-like ulcer or niche in the esophageal wall, with disappearance or atypical folds distal to the crater, spasm above the lesion, and narrowing due to edema.
2. Esophagoscopy shows a crater-like ulcer focus, unclear mucosal folds, inflammatory edema, hemorrhage, and leukoplakia. No malignant cells are found in exfoliative cytology.bubble_chart Treatment Measures
Treatment often requires surgical intervention. Medication may include the use of mucosal protective agents such as sucralfate, along with H2-receptor blockers or proton pump inhibitors. Prokinetic agents like cisapride can be effective in preventing esophageal reflux, typically administered at 5–10 mg per dose, three times daily.
