Barrett's esophagus (oesophagus) (sometimes called Barrett's syndrome, CELLO, columnar epithelium lined lower esophagus and colloquially referred to as Barrett's) refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis.
The normal lining of the esophagus (squamous epithelium) is replaced by an intestinal-type lining (columnar epithelium). This replacement, however, is more cosmetic than substantive, because genetic analyses and kinome profiles indicate that the changed cells, which phenotypically appear to be columnar epithelium, actually retain important aspects of squamous epithelium on a molecular level.
Barrett's esophagus is found in 5-15% of patients who seek medical care for heartburn (gastroesophageal reflux disease, GERD), although a large subgroup of patients with Barrett's esophagus do not have symptoms.
Diagnosis of Barrett's esophagus requires endoscopy (more specifically, esophagogastroduodenoscopy, a procedure in which a small tube with a camera at the top is used to look at the esophagus, stomach and first part of the bowels) and biopsy (taking small tissue samples which are analysed using microscopy).
The progression from Barrett's esophagus to esophageal cancer is divided into non-dysplastic changes, low-grade and high-grade dysplasia (abnormal cell maturation associated with a risk of progression to cancer) and frank carcinoma.
In high-grade dysplasia, the risk of developing cancer might be at 10% per patient-year or greater.
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