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	<title>Esophageal Conditions and Treatments | UCLA Center For Esophageal Disorders - Los Angeles, CA</title>
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												<h1 class="pagetitle" id="pagetitle"><strong>Esophageal Conditions and Treatments</strong></h1>
											
										
										
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			<b>Esophageal Conditions</b><hr>
		
				<li class="sectionlinks">
					
						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=1&oTopID=0&action=detail'>Achalasia</a>
					
				</li>
			
				<li class="sectionlinks">
					
						<div class="metadetail"><b>Barrett’s Esophagus</b></div>
					
				</li>
			
				<li class="sectionlinks">
					
						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=5&oTopID=0&action=detail'>Diffuse Esophageal Spasm (DES)</a>
					
				</li>
			
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						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=6&oTopID=0&action=detail'>Esophageal Cancer</a>
					
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						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=7&oTopID=0&action=detail'>Gastroesophageal Reflux Disease (GERD)</a>
					
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				<li class="sectionlinks">
					
						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=8&oTopID=0&action=detail'>Hiatal Hernia</a>
					
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				<li class="sectionlinks">
					
						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=9&oTopID=0&action=detail'>Nutcracker Esophagus</a>
					
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						<a href='http://esophagealcenter.ucla.edu/body.cfm?xyzpdqabc=0&id=27&ref=10&oTopID=0&action=detail'>Scleroderma</a>
					
				</li>
			
			<h2>Barrett’s Esophagus</h2>
			<p>
<strong>What is Barrett&rsquo;s Esophagus? <a href="workfiles/conditions/Barretts.pdf" target="_blank">PDF Version</a></strong><br />
Barrett&rsquo;s Esophagus occurs when abnormal growth of intestinal-like cells form in the lining of the esophagus. The lining of the esophagus differs from that of the stomach and intestines, and is different in appearance, so it is usually easy for your physician to determine if such abnormal growth has occurred. It is believed that the abnormal growth that causes Barrett&rsquo;s is actually one of the means by which the body responds to injury. Unfortunately, the growth of these cells leads to a condition that increases the risk for a form of cancer found in the lower esophagus known as adenocarcinoma. 
</p>
<p>
<strong>What symptoms will I experience if I have Barrett&rsquo;s Esophagus?</strong><strong><br />
</strong>While there are cases of Barrett&#39;s Esophagus being present at birth, the most common reason for developing Barrett&#39;s Esophagus is the presence of chronic GERD. Therefore, patients with Barrett&#39;s Esophagus will experience the same symptoms as patients with GERD: heartburn, regurgitation and an acid/sour taste in the back of the mouth. Patients who have developed Barrett&#39;s Esophagus may experience some of the more serious side effects of GERD, such as esophageal peptic ulcers and stricture, or the narrowing of the esophagus due to scarring. 
</p>
<p>
<strong>How is it diagnosed?</strong><strong><br />
</strong>If you, or your doctor, feel that you may be at risk for Barrett&#39;s Esophagus, an upper endoscopy or EGD ( esophagogastroduodenoscopy) will be performed. This is when a small, flexible tube that has a light and a camera is inserted orally and travels down your esophagus, where your physician can view the cells that line your esophagus. In addition, biopsies can be taken that will be studied by a pathologist to determine the changes, or dysplasia, that has occurred. Generally, your physician will want to repeat the procedure at regular intervals in order to properly monitor the changes that occur in your esophagus. 
</p>
<p>
<strong>What is the treatment process for Barrett&#39;s Esophagus?</strong><strong><br />
</strong>The treatment process for Barrett&#39;s Esophagus is similar to that of GERD, however, treatment becomes even more important when you have become diagnosed with Barrett&#39;s Esophagus, as your esophagus is already beginning to make changes that can affect your long-term health. It is felt that the best method of treating Barrett&#39;s Esophagus is to treat the underlying symptoms. This can be achieved through a variety of methods. 
</p>
<p>
There are medications that can help to control your reflux. Proton pump inhibitors, which reduce the production of gastric acid, are the mainstay of therapy. They include Prilosec&copy;, Prevacid&copy;, Protonix&copy;, Aciphex&copy; and Nexium&copy;. These medications are generally taken once or twice per day and may be a required treatment throughout your life. 
</p>
<p>
A change in diet and lifestyle to eliminate foods and behaviors, such as smoking, may reduce reflux. Obesity may be a contributing factor. Unfortunately, eliminating the necessary foods, and completely controlling reflux through diet modification is extremely difficult. 
</p>
<p>
There are two important factors in treating Barrett&#39;s Esophagus&mdash;treating the symptoms and treating the problem. 
</p>
<p>
The problem in patients with Barrett&#39;s Esophagus, similar to those with other forms of reflux disease, is a malfunctioning lower esophageal sphincter. This valve controls the passage of food from the esophagus into the stomach. When it is weak it does not close properly allowing food, acid, bile and other substances to pass back into the esophagus causing GERD and Barrett&#39;s Esophagus. Many patients have a normal pressure in the sphincter muscle, but suffer because of the excessive number of times the muscle relaxes. The symptoms of GERD, including those with Barrett&#39;s Esophagus, may be controlled with medication and diet modification. Occasionally, patients may suffer from nonaciditic reflux and may require more aggressive treatment. 
</p>
<p>
Additional Treatment Strategies: 
</p>
<p>
<strong>Laparoscopic Nissen fundoplication</strong> 
</p>
<ul>
	<li>This is a surgery done to treat reflux. Five small incisions are made in the abdomen, where cameras and surgical instruments are placed. The fundus of the stomach is wrapped around the lower portion of the esophagus. This will create a new &quot;valve&quot; between the esophagus and stomach to prevent reflux from occurring. </li>
</ul>
<p>
<strong>Endoscopic procedure</strong> 
</p>
<ul>
	<li><strong>Ablation</strong>: Endoscopic ablation techniques involving thermal destruction of the abnormal lining cells in the esophagus are now available for patients with cellular changes of either early cancer or highly precancerous characteristics. </li>
</ul>
<p>
<font color="#000000"></font>
</p>
<p>
<strong><font color="#000000">Discharge Instructions after Barrett&#39;s ablation</font></strong> (<a href="workfiles/surgery/inst_barrettsabl.pdf">Print version/PDF</a>) 
</p>
<p>
<font color="#000000">You may experience one or more of the following symptoms after treatment:</font> 
</p>
<ul>
	<li>Chest discomfort</li>
	<li>Sore throat</li>
	<li>Difficulty or pain with swallowing</li>
	<li>Nausea/vomitting</li>
</ul>
<p>
<font color="#000000">These symptoms should improve each day.&nbsp; You will be provided with medications and specific instructions to make you as comfortable as possible during this time.&nbsp; Should any of your symptoms be more severe in nature or longer in duration tan we have described, please contact us.&nbsp; It is important to continue a strict and long-term regimen of anti-acid medication after this treatment- such as Nexium or another similar drug.</font> 
</p>
<ul>
	<li>Take your anti-acid medication twice a day for 3 months</li>
	<li>You can take Maalox by mouth as needed</li>
	<li>Take liquid Tylenol as needed for pain or discomfort</li>
	<li>If you feel nauseous, you can take medication that has been prescribed</li>
	<li>Eat a <a href="workfiles/treatments/fldiet.pdf">full liquid diet</a> (click to print) for 24 hours and then advance to a <a href="workfiles/treatments/Softdiet.pdf">soft diet</a> for 1 week.</li>
	<li>Avoid aspirin or ibruprofen (motrin, advil) for 7 days.</li>
</ul>
<p>
<font color="#000000">Contact your doctor&#39;s office immediately for significant chest pain, difficulty swallowing, fever, bleeding, abdominal pain, difficulty breathing or vomitting.</font> 
</p>
<p>
<font color="#000000">Who to call:</font> 
</p>
<p>
<font color="#000000">Monday- Friday 8-5 call Becky Allegretto, RN 310-825-6167</font> 
</p>
<p>
<font color="#000000">After hours/weekends/holidays- call the pager operator 310-206-6766 and ask to speak to the &quot;thoracic resident on call&quot;</font> 
</p>
<p>
&nbsp;
</p>
<p>
<strong>What happens if Barrett&#39;s Esophagus is not treated?</strong><strong><br />
</strong>If left untreated, Barrett&#39;s Esophagus may progress to cancer. The intestinal cells that line the esophagus can change from normal, to dysplasia (abnormal) to cancer (malignant). Why these cells continue to progress is not well understood. However, once dysplasia is present, a patient has a 0.5% risk per year of going on to develop cancer in the esophagus. Diligent surveillance and aggressive treatment may reduce the further development of Barrett&rsquo;s esophagus and allow for early diagnosis of premalignant or malignant changes. 
</p>
<p>
<strong>Where can I learn more about Barrett&#39;s Esophagus? </strong>
</p>
<ul>
	<li><a href="http://www.acg.gi.org/" target="_blank">American College of Gastroenterology</a> </li>
	<li><a href="http://www.gastro.org/wmspage.cfm?parm1=2" target="_blank">American Gastroenterological Association</a> </li>
	<li><a href="http://www.sts.org/doc/4121" target="_blank">STS Organization (The Society of Thoracic Surgeons)</a> </li>
	<li><a href="http://barrettsinfo.com/" target="_blank">barrettsinfo.com</a> </li>
</ul>

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