Barrett's esophagus natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Common complications of [[Barrett's esophagus]] include [[esophageal carcinoma]], [[esophageal stricture]] and [[esophageal]] [[ulcers]] | Common complications of [[Barrett's esophagus]] include [[esophageal carcinoma]], [[esophageal stricture]] and [[esophageal]] [[ulcers]]. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
Barrett's esophagus is associated with increased risk of [[esophageal cancer]]. Follow-up [[endoscopy]] is recommended for [[dysplasia]] or [[cancer]] evaluation. | |||
*The symptoms of | *The symptoms of Barrett's esophagus usually develop in the fifth/sixth decade of life, and start with symptoms of [[GERD]] such as [[heartburn]], [[regurgitation]] and [[dysphagia]]. | ||
*If left untreated, 100 to 400 out of 100,000 patients with [[Barrett's esophagus]] may progress to develop [[Esophageal Cancer|esophageal adenocarcinoma]]. <ref name="pmid9040193">{{cite journal| author=Drewitz DJ, Sampliner RE, Garewal HS| title=The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years. | journal=Am J Gastroenterol | year= 1997 | volume= 92 | issue= 2 | pages= 212-5 | pmid=9040193 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9040193 }} </ref><ref name="pmid11448658">{{cite journal| author=Eckardt VF, Kanzler G, Bernhard G| title=Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation. | journal=Am J Med | year= 2001 | volume= 111 | issue= 1 | pages= 33-7 | pmid=11448658 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11448658 }} </ref><ref name="pmid18045592">{{cite journal| author=Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P| title=Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis. | journal=Gastrointest Endosc | year= 2008 | volume= 67 | issue= 3 | pages= 394-8 | pmid=18045592 | doi=10.1016/j.gie.2007.07.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18045592 }} </ref><ref name="pmid16630761">{{cite journal| author=Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE| title=Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus. | journal=Clin Gastroenterol Hepatol | year= 2006 | volume= 4 | issue= 5 | pages= 566-72 | pmid=16630761 | doi=10.1016/j.cgh.2006.03.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16630761 }} </ref><ref name="pmid21997553">{{cite journal| author=Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S et al.| title=The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis. | journal=Gut | year= 2012 | volume= 61 | issue= 7 | pages= 970-6 | pmid=21997553 | doi=10.1136/gutjnl-2011-300730 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21997553 }} </ref> | |||
*If left untreated, | |||
===Complications=== | ===Complications=== | ||
*Common complications of [[Barrett's esophagus]] include: | *Common complications of [[Barrett's esophagus]] include: | ||
**[[Esophageal carcinoma]]<ref name="pmid21995385">{{cite journal| author=Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P| title=Incidence of adenocarcinoma among patients with Barrett's esophagus. | journal=N Engl J Med | year= 2011 | volume= 365 | issue= 15 | pages= 1375-83 | pmid=21995385 | doi=10.1056/NEJMoa1103042 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21995385 }} </ref> | **[[Esophageal carcinoma]]<ref name="pmid21995385">{{cite journal| author=Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P| title=Incidence of adenocarcinoma among patients with Barrett's esophagus. | journal=N Engl J Med | year= 2011 | volume= 365 | issue= 15 | pages= 1375-83 | pmid=21995385 | doi=10.1056/NEJMoa1103042 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21995385 }} </ref> | ||
**[[Esophageal stricture]] | **[[Esophageal stricture]]<ref name="pmid22826612">{{cite journal| author=Milind R, Attwood SE| title=Natural history of Barrett's esophagus. | journal=World J Gastroenterol | year= 2012 | volume= 18 | issue= 27 | pages= 3483-91 | pmid=22826612 | doi=10.3748/wjg.v18.i27.3483 | pmc=3400849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22826612 }} </ref> | ||
**[[Esophageal]] [[ulcers]] | **[[Esophageal]] [[ulcers]]<ref name="pmid22826612">{{cite journal| author=Milind R, Attwood SE| title=Natural history of Barrett's esophagus. | journal=World J Gastroenterol | year= 2012 | volume= 18 | issue= 27 | pages= 3483-91 | pmid=22826612 | doi=10.3748/wjg.v18.i27.3483 | pmc=3400849 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22826612 }} </ref> | ||
Progression | === Progression === | ||
* From low-grade [[dysplasia]] to high-grade [[dysplasia]] or [[esophageal]] [[adenocarcinoma]]: 0.5 to 13.4% per [[year]] | * From low-grade [[dysplasia]] to high-grade [[dysplasia]] or [[esophageal]] [[adenocarcinoma]]: 0.5 to 13.4% per [[year]] | ||
* From high-grade [[dysplasia]] to [[cancer]]: 6% per [[year]] | * From high-grade [[dysplasia]] to [[cancer]]: 6% per [[year]]<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |month=March |pmid=21376940 |doi=10.1053/j.gastro.2011.01.030 |url=}}</ref> | ||
==Prognosis== | ==Prognosis== | ||
*Prognosis is generally | *[[Prognosis]] is generally good for [[Barrett's esophagus]], but if it is associated with [[esophageal]] [[adenocarcinoma]] then 5 year survival rate of [[patients]] with [[Barrett's esophagus]] is approximately 20%.<ref name="SEER">Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.</ref> | ||
==References== | ==References== | ||
Latest revision as of 17:25, 21 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amresh Kumar MD [2]
Overview
Common complications of Barrett's esophagus include esophageal carcinoma, esophageal stricture and esophageal ulcers.
Natural History, Complications, and Prognosis
Natural History
Barrett's esophagus is associated with increased risk of esophageal cancer. Follow-up endoscopy is recommended for dysplasia or cancer evaluation.
- The symptoms of Barrett's esophagus usually develop in the fifth/sixth decade of life, and start with symptoms of GERD such as heartburn, regurgitation and dysphagia.
- If left untreated, 100 to 400 out of 100,000 patients with Barrett's esophagus may progress to develop esophageal adenocarcinoma. [1][2][3][4][5]
Complications
- Common complications of Barrett's esophagus include:
Progression
- From low-grade dysplasia to high-grade dysplasia or esophageal adenocarcinoma: 0.5 to 13.4% per year
- From high-grade dysplasia to cancer: 6% per year[8]
Prognosis
- Prognosis is generally good for Barrett's esophagus, but if it is associated with esophageal adenocarcinoma then 5 year survival rate of patients with Barrett's esophagus is approximately 20%.[9]
References
- ↑ Drewitz DJ, Sampliner RE, Garewal HS (1997). "The incidence of adenocarcinoma in Barrett's esophagus: a prospective study of 170 patients followed 4.8 years". Am J Gastroenterol. 92 (2): 212–5. PMID 9040193.
- ↑ Eckardt VF, Kanzler G, Bernhard G (2001). "Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation". Am J Med. 111 (1): 33–7. PMID 11448658.
- ↑ Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P (2008). "Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis". Gastrointest Endosc. 67 (3): 394–8. doi:10.1016/j.gie.2007.07.019. PMID 18045592.
- ↑ Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE (2006). "Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus". Clin Gastroenterol Hepatol. 4 (5): 566–72. doi:10.1016/j.cgh.2006.03.001. PMID 16630761.
- ↑ Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S; et al. (2012). "The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis". Gut. 61 (7): 970–6. doi:10.1136/gutjnl-2011-300730. PMID 21997553.
- ↑ Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P (2011). "Incidence of adenocarcinoma among patients with Barrett's esophagus". N Engl J Med. 365 (15): 1375–83. doi:10.1056/NEJMoa1103042. PMID 21995385.
- ↑ 7.0 7.1 Milind R, Attwood SE (2012). "Natural history of Barrett's esophagus". World J Gastroenterol. 18 (27): 3483–91. doi:10.3748/wjg.v18.i27.3483. PMC 3400849. PMID 22826612.
- ↑ Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (2011). "American Gastroenterological Association medical position statement on the management of Barrett's esophagus". Gastroenterology. 140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030. PMID 21376940. Unknown parameter
|month=ignored (help) - ↑ Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.