Barrett's esophagus refers to a pathological condition where the stratified squamous epithelium in the lower esophagus is replaced by simple columnar epithelium. It may not present any specific symptoms on its own, but when esophagitis, ulcers, or cancerous changes occur, corresponding reflux symptoms may appear. Some Barrett's epithelium is prone to malignant transformation.

bubble_chart Diagnosis

Currently, Barrett's esophagus is considered to be the result of congenital esophageal epithelial dysplasia or long-term reflux. Therefore, for individuals with symptoms such as non-cardiac retrosternal pain, acid reflux, odynophagia, and/or dysphagia, barium swallow X-ray examination and esophagoscopy should be performed as early as possible. Barium meal X-ray can help determine the presence of reflux-related conditions such as esophageal ulcers and hiatal hernias. Endoscopy is the definitive diagnostic method, focusing on signs such as the disappearance or upward displacement of the dentate line, island-like distribution of orange-red or bright red columnar epithelial mucosal areas, and complications like ulcers or strictures. Biopsy samples taken during endoscopy can differentiate between squamous and columnar epithelium.

bubble_chart Treatment Measures

The primary treatment focuses on acid suppression and anti-reflux therapy. Options include proton pump inhibitors such as omeprazole 20mg once or twice daily, or H2 receptor antagonists like cimetidine 0.4g twice daily or 0.8g once nightly, along with prokinetic agents such as domperidone 10mg three times daily or cisapride 5–10mg three times daily. After reflux correction, some Barrett's epithelium may revert to squamous epithelium. If medical anti-reflux therapy fails, surgical treatment may be considered. During medical therapy, regular endoscopic follow-up is necessary to monitor treatment efficacy. Once reversal occurs, the risk of cancer can be reduced.