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Related Concept Videos

Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
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An Immunofluorescent Method for Characterization of Barrett’s Esophagus Cells
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Endoscopic therapy for Barrett's oesophagus.

Christopher H Blevins1, Prasad G Iyer2

  • 1Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Best Practice & Research. Clinical Gastroenterology
|March 7, 2015
PubMed
Summary

Barrett's oesophagus endoscopic therapy aims to eliminate metaplastic and dysplastic cells, preventing progression to oesophageal adenocarcinoma. Continued surveillance is crucial post-treatment to manage potential recurrences.

Keywords:
Barrett's OesophagusCryotherapyEndoscopic mucosal resectionEndoscopic submucosal dissectionEndotherapyOesophageal adenocarcinomaRadiofrequency ablation

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Area of Science:

  • Gastroenterology
  • Oncology
  • Endoscopic Surgery

Background:

  • Barrett's oesophagus (BO) is a precursor to oesophageal adenocarcinoma (OAC), a cancer with poor survival rates.
  • The progression involves low-grade dysplasia (LGD) and high-grade dysplasia (HGD) before OAC develops.
  • Endoscopic therapy aims to eradicate metaplastic and dysplastic epithelium to prevent OAC.
  • Established endoscopic techniques include tissue acquisition (endoscopic mucosal resection, endoscopic submucosal dissection) and ablative methods.

Purpose of the Study:

  • To outline the goals and methods of endoscopic therapy for Barrett's oesophagus.
  • To highlight the efficacy of endoscopic therapy for intra-mucosal cancer (IMC), HGD, and LGD.
  • To identify challenges and the necessity of ongoing surveillance after treatment.

Main Methods:

  • Review of endoscopic therapy techniques for Barrett's oesophagus.
  • Categorization of techniques into tissue-acquiring and ablative methods.
  • Assessment of safety and efficacy for various stages of dysplasia and early cancer.

Main Results:

  • Endoscopic therapy is safe and effective for IMC, HGD, and LGD in BO.
  • Tissue acquisition and ablative techniques are complementary approaches.
  • Challenges include incomplete response and recurrence post-therapy.

Conclusions:

  • Endoscopic therapy is a key strategy to prevent OAC progression in BO patients.
  • Complete eradication of intestinal metaplasia is the primary goal.
  • Long-term surveillance is essential to detect and manage recurrences after successful eradication.