G111
BARRETT'S ESOPHAGUS
If you suffer from belching and burning in your stomach, your doctor will often recommend that you have a tube placed down your throat and into your stomach to check for cancer and stomach ulcers. Sometimes, the doctor finds Barrett' esophagus, stomach tissue in your esophagus which can become cancerous. There is no established treatment for Barrett's esophagus. Food passes down a narrow tube called the esophagus and into a wider area called the stomach. The tissue covering the inner lining of the stomach is different from that lining the esophagus.
If your doctor finds stomach-lining cells in your esophagus, he diagnoses Barrett's esophagus, which can turn to cancer. However, this happens so seldom that rather than cutting out your esophagus, most doctors recommend checking you yearly to see if the cells become cancerous. We know that most people with stomach ulcers are infected with a family of bacteria called helicobacter. However, most of the people who have Barrett's esophagus do not have helicobacter. Those who have both helicobacter and Barrett's esophagus all have severe redness, swelling and irritation (1). So all people with helicobacter and Barrett's esophagus should be treated with the standard two antibiotics and one ulcer medicine that are used to cure helicobacter in people with stomach irritation.
A study from Japan shows that men who are treated with antibiotics for Helicobacter, the germ that causes stomach ulcers, are not at increased risk for Barrett's esophagus (3). Some doctors will not treat people who are infected with a bacteria called helicobacter because they think that getting rid of Helicobacter increases stomach acidity, causing belching and burning and a precancerous condition called Barrett's esophagus. They think that helicobacter is good because it destroys the stomach lining and its ability to make acid, and that acid going into the esophagus causes esophageal cancer.
This study confirms more than a thousand other studies showing that helicobacter can cause stomach ulcers, and it also shows that three years later, cured patients are asymptomatic and do not suffer an increased incidence of Barrett's esophagus. See also report #G123.
1) RDJ Henihan, RC Stuart, N Nolan, TF Gorey, TPJ Hennessy, CA Omorain. Barrett's esophagus and the presence of Helicobacter pylori. American Journal of Gastroenterology 93: 4 (APR 1998):542-546.
2) RM Navaratnam, MC Winslet. Barrett's oesophagus. Postgraduate Medical Journal 74: 877 (NOV 1998):653-657.
3) Improvement of reflux symptoms 3 years after cure of Helicobacter pylori infection: A case-controlled study in the Japanese population. Helicobacter, 2002, Vol 7, Iss 4, pp 219-224. H Miwa, Y Sugiyama, T Ohkusa, A Kurosawa, M Hojo, T Yokoyama, T Hamada, H Basyuda, N Sato. Sato N, Juntendo Univ, Sch Med, Dept Gastroenterol, Tokyo 113, JAPAN
Checked 8/9/05