Barrett's oesophagus: Intestinal metaplasia is not essential for cancer risk

2007 ◽  
Vol 42 (11) ◽  
pp. 1271-1274 ◽  
Author(s):  
Clive J. Kelty ◽  
Martin D. Gough ◽  
Quintin Van Wyk ◽  
Timothy J. Stephenson ◽  
Roger Ackroyd
Keyword(s):  
Cancer Risk ◽  
Intestinal Metaplasia ◽  
Barrett’S Oesophagus ◽  
Barrett's Oesophagus

Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development

2016 ◽  
Vol 48 (2) ◽  
pp. 144-147 ◽  
Author(s):  
Marianna Salemme ◽  
Vincenzo Villanacci ◽  
Gianpaolo Cengia ◽  
Renzo Cestari ◽  
Guido Missale ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Cancer Development ◽  
Barrett’S Oesophagus ◽  
Essential Factor ◽  
Barrett's Oesophagus

scholarly journals Does anti-reflux surgery control Barrett’s oesophagus progression?

2018 ◽  
Vol 5 (7) ◽  
pp. 2388
Author(s):  
Ali J. Alghazzawi ◽  
Ali A. Khabaza ◽  
Mohammed H. Al-Hijaji
Keyword(s):  
Intestinal Metaplasia ◽  
De Novo ◽  
Barrett’S Oesophagus ◽  
Electronic Database ◽  
Barrett's Oesophagus ◽  
Ovid Medline ◽  
Effective Option ◽  
Gastric Reflux

Controversy exists as to whether or not anti-reflux surgery can prevent the potential long-term complications of Barrett's oesophagus, in particular, dysplastic changes. Hence, literature was reviewed to find out effects of anti-reflux surgery on patients with Barrett's oesophagus. Data has been analysed using different electronic database including Ovid Medline, Scopus, Google Scholar and PubMed. Anti-reflux surgery is considered an effective option for rapid and long-term control of reflux symptoms. Most patients who were included in the studies had a satisfactory control of their symptoms after surgery. Successful procedures effectively abolished gastric reflux in the majority of patients. On the other hand, there were different patterns of Barrett's oesophagus segment progression after surgery regardless of the procedure's success. Many patients developed de novo Barrett's oesophagus, at the same time the intestinal metaplasia regressed in other patients, but the Barrett segment has remained unchanged in the majority of patients. Similarly, the pattern of dysplasia progression was different among patients. Surgery was effective in producing dysplasia regression in many patients, but it failed to prevent progression of columnar intestinal metaplasia into dysplasia in other patients.  In conclusion the potential long-term complications of Barrett's oesophagus can develop after anti-reflux surgery. Therefore, long life follow- up, after surgery, is mandatory.

scholarly journals Comparative quantitative survey of patient experience in Barrett’s oesophagus and other gastrointestinal disorders

2020 ◽  
Vol 7 (1) ◽  
pp. e000357
Author(s):  
James Britton ◽  
Paraskevi Taxiarchi ◽  
Glen Martin ◽  
Robert Willert ◽  
Maria Horne ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Symptom Control ◽  
Rank Correlation ◽  
Colonic Polyps ◽  
Colonic Polyp ◽  
Barrett’S Oesophagus ◽  
Cancer Worry ◽  
Barrett's Oesophagus ◽  
Acid Regurgitation ◽  
Spearman’S Rank Correlation

ObjectiveTo assess health-related quality of life in patients with non-dysplastic Barrett’s oesophagus (NDBO) and endoscopically treated dysplastic Barrett’s oesophagus (DBO).DesignThis quantitative, self-administered questionnaire study was conducted across three National Health Service hospitals. Data were collected from three other cohorts; gastro-oesophageal reflux disease (GORD), colonic polyp surveillance and healthy individuals. Fisher’s exact and Spearman’s rank correlation tests were used for analysis. Propensity score matching adjusted for age, sex and comorbidities.Results687 participants were eligible for analysis (NDBO n=306, DBO n=49, GORD n=132, colonic polyps n=152 and healthy n=48). 53% of NDBO participants reported similarly high cancer worry, comparable to DBO (50%, p=0.933) and colonic polyp participants (51%, p=0.355). Less cancer worry was reported in GORD participants (43.4%, p=0.01 vs NDBO). NDBO participants reported anxiety in 15.8% and depression in 8.6% of cases, which was similar to the other disease cohorts. Moderate or severe heartburn or acid regurgitation was found in 11% and 10%, respectively, in the NDBO cohort, comparable to DBO participants (heartburn 2% p=0.172, acid regurgitation 4% p=0.31) but lower (better) than GORD participants (heartburn 31% p=<0.001, acid regurgitation 25% p=0.001). NDBO participants with moderate or severe GORD symptoms were associated with higher rates of anxiety (p=<0.001), depression (p=<0.001) and cancer worry (p=<0.001). NDBO patients appropriately perceiving their cancer risk as low had lower rates of cancer worry (p=<0.001).ConclusionThis study provides insight into the problems Barrett’s oesophagus patients may face. Future care pathways must be more patient focussed to address misconceptions of cancer risk, oesophageal cancer related worry and GORD symptom control.

scholarly journals Barrett's oesophagus: epidemiology, cancer risk and implications for management

Gut ◽  
2013 ◽  
Vol 63 (1) ◽  
pp. 191-202 ◽  
Author(s):  
Pieter Jan F de Jonge ◽  
Mark van Blankenstein ◽  
William M Grady ◽  
Ernst J Kuipers
Keyword(s):  
Cancer Risk ◽  
Barrett’S Oesophagus ◽  
Barrett's Oesophagus

A Comparative Study between Nissen's Fundoplication with or without Endoscopic Mucosal Resection in the Treatment of Barrett’s Oesophagus: a Meta-Analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Abdallah Elfeky ◽  
Amr Mohamed Mahmoud El-Hefny ◽  
Ayman Hossam-ElDin ◽  
Mark Medhat Fathy
Keyword(s):  
Intestinal Metaplasia ◽  
Endoscopic Mucosal Resection ◽  
Endoscopic Therapy ◽  
High Rate ◽  
Barrett’S Oesophagus ◽  
Low Grade ◽  
Recurrence Rates ◽  
Barrett's Oesophagus ◽  
Endoscopic Procedures ◽  
Mucosal Resection

Abstract Background It is already known that Barrett’s esophagus (BE) is a premalignant condition in which the normal squamous epithelium of the distal esophagus is replaced by columnar epithelium (intestinal metaplasia or gastric metaplasia) due to GERD. Most observers believe that there is a progression from intestinal metaplasia to low-grade dysplasia (LGD) to highgrade dysplasia (HGD) to cancer. The relative risk of developing esophageal adenocarcinoma in patients with BE appears to be 30-fold higher. Conventional therapies include medical treatment (profound acid inhibition), endoscopic treatment (like endoscopic mucosal resection) and surgical treatment (fundoplication). Methodology Types of studies: Published studies about the efficacy of Nissen’s Fundoplication with or without Endoscopic Mucosal Resection in the treatment of Barrett’s Oesophagus (carried out in the period between 2015 – 2020), types of participants Patients with clinically proven Barrett’s Oesophagus diagnosed by endoscopy and biopsy, types of interventions Nissen’s Fundoplication (Open or Laparoscopic) with or without Endoscopic Mucosal Resection, types of outcome measures Outcome of treatment in the form of Complete Remission of Columnar Metaplasia of the oesophageal mucosa or regression in recurrence rate as proved by follow-up endoscopy. Results The strategy of endoscopic therapy for Barrett’s metaplasia, dysplasia and/or intramucosal cancer along with fundoplication results in similar durability and recurrence rates when compared to patients being managed with PPIs following endoscopic therapy. However, fundoplication along with endoscopic therapy is superior to either of them alone in preventing further progression of disease and the development of cancer, particularly in refractory patients. Fundoplication is an important strategy along with endoscopic therapy for Barrett’s to achieve and maintain CR-IM, and to facilitate the eradication of persistent dysplasia. Conclusion Endoscopic mucosal resection after Nissen's Fundoplication is a safe modality, with high rate of success in complete eradication of BE in symptomatic GERD patients, especially those with severe anatomical impairment in distal esophageal segment. As a concurrent procedure, endoscopic procedures may be beneficial in the terms of reducing the early recurrence rates, which seems to be important issue during the management of BE. By doing synchronous endoscopic procedures and fundoplication, one might observe a true anatomy of esophagogastric junction in its entirety and might be able to truly observe the distal extent of columnar esophagus.

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