Barrett's esophagus Tteatment

Purpose of Barrett's esophagus treatment include control gastroesophageal reflux, mitigate the symptoms, prevention and treatment of complications and reduce the risk of malignant transformation.

1. Medical treatment. It is Barrett's esophagus first choice for treatment. No symptoms and complications, no need for surgical treatment. It is mainly to change the bad habits such as diet to reduce intake of irritation, bed elevation, elimination of tobacco and alcohol, avoid to eat chocolate food which inhibition of lower esophageal sphincter tension. Drug treatment of multiple choice H2 receptor antagonists and proton pump inhibitors, treatment with prokinetic drugs. For Barrett Ulcer: Clinical data show that although some patients significantly reduced acid secretion, ulcer healing, gastroesophageal reflux but there are still, after further research found that in patients with Barrett esophagus, gastroesophageal reflux were not only acidic, but alkaline material. It is therefore speculated that the current treatment methods are mainly esophagus and stomach by changing the pH value to reduce the symptoms of gastroesophageal reflux, and can not prevent anti-alkaline gastric contents into the esophagus, so the drug treatment, the symptoms caused by acid brought under control, and alkaline reflux persists, continue to undermine the esophageal mucosa. Stenosis in patients with Barrett for most of the expansion of therapy and medication have a good response. Especially in the repeated expansion, the symptoms of dysphagia can be eased.

2. Surgical treatment. Applicable to medical treatment does not work, continue to have symptoms and complications of patients, surgical treatment is aimed at inhibiting reflux to prevent the continued development of columnar epithelium and extending upward. Starnes and other pointed out that the clinic only 15% of Barrett esophagus patients were better after treatment, while the remaining 85% is ineffective. At present, most scholars advocate of Barrett esophagus patients are asymptomatic, regardless of their, as long as the objective existence of gastroesophageal reflux (esophageal pH monitoring positive), biopsy or intestinal metaplasia with any degree of epithelial dysplasia, are the need for anti - reflux surgery, especially those with reflux esophagitis, ulcers or stenosis patients, must be thoroughly correct reflux. Therefore believe that Barrett's esophagus patients have the surgery as long as the conditions, especially young patients, short and drug treatment history of ineffective or difficult to control the development of complications in patients, consideration should be given anti-reflux surgery line.

Treatment of Barrett esophagus to Nissen fundoplication is the preferred surgical plication. The effect of various treatment 24h pH should be measured through the esophagus, endoscopy and clinical performance evaluation. In addition, after the operation should be conducted regularly in endoscopy and biopsy. Successful anti-reflux surgery can be columnar epithelium degeneration, such as post-operative anti-reflux reflux still, no doubt the continued existence of the risk of cancer. However, the success of anti-reflux after the surgery, still in the columnar epithelium lining the esophageal adenocarcinoma epithelial occurred. Barrett esophagus are of the view that the most effective treatment is surgery. Where, as confirmed by endoscopic and pathological Barrett esophageal surgery should be implemented as soon as possible. Surgical resection with esophageal cancer, gastrointestinal tract reconstruction using stomach or colon residues, with a small number of Campylobacter. Surgical mortality rate was 0 ~ 10%.