Treating Barrett's Esophagus

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Barrett's esophagus is a disorder in which the lining of the esophagus is damaged. This damage occurs when parts of the esophageal lining are repeatedly exposed to stomach acid, and are replaced by tissue that is similar to what is found intestine. This process is called intestinal metaplasia.

When stomach acid backs up into the esophagus, it can cause injury to the normal lining of the esophagus. Esophageal injury with inflammation is called esophagitis.

If this injury to the esophagus continues over many years, the injured normal lining of the esophagus will not grow back. Instead, it is replaced by an abnormal lining

Currently, there are no medications that will reverse Barrett's esophagus. Treating underlying GERD, however, may slow the progress of the disease and help prevent complications.

The best treatment strategy for Barrett's esophagus is prevention. When people are diagnosed with GERD, their doctors will work with them on lifestyle and diet modifications and may suggest medications to control the acid reflux.

Lifestyle modifications to help reduce GERD symptoms include:

  • Eating smaller, more frequent meals
  • Limiting intake of acid-stimulating foods and beverages
  • Not laying down for about two hours after you eat
  • Elevating the head a few inches while you sleep
  • Maintaining a reasonable weight
  • Quitting smoking
  • Avoiding alcohol
  • Not wearing belts or clothes that are tight-fitting around the waist
  • Taking any doctor-prescribed medications for acid reflux symptoms

Some acid-stimulating foods and beverages that should be cut back on, or out of, one's diet include:

Foods that can relax the LES:

  • Fried (greasy) foods
  • High fat meats
  • Butter and margarine
  • Mayonnaise
  • Creamy sauces
  • Salad dressings
  • Whole-milk dairy products
  • Chocolate
  • Peppermint
  • Caffeinated beverages (e.g. soft drinks, coffee, tea, cocoa)

Foods that may stimulate acid production and increase heartburn:

  • Caffeinated beverages
  • Carbonated beverages
  • Alcohol
  • Spicy foods
  • Black pepper
  • Citrus fruit and juices (e.g. orange, grapefruit)
  • Tomato juice

A partial list of foods that are safe for heartburn sufferers to eat:

  • Apples
  • Bananas
  • Baked potatoes
  • Broccoli
  • Carrots
  • Green beans
  • Peas
  • Lean ground beef
  • Lean pork tenderloin
  • Lean pork chops
  • Lean turkey
  • Lean ham
  • Skinless chicken breasts
  • Fish
  • Eggs
  • Low-fat cheeses (in moderation)
  • Bread
  • Corn bread
  • Rice
  • Pasta
  • Decaffeinated, non-carbonated beverages
  • Non-citrus fruit juices
  • Water

A physician may also prescribe antacids, proton pump inhibitors, or H2 blockers to reduce the occurrence of reflux.

Antacids
Antacids are useful in relieving the occasional heartburn and indigestion. The active ingredient in antacids neutralizes stomach acid, which is what is causing the pain. These include:

H2 Blockers
H2 blockers suppress acid production in the stomach.

 H2 blockers, also called H2-receptor antagonists, are acid-reducing medicines commonly used to treat gastroesophageal reflux disease and esophagitis, and to reduce the symptoms of peptic ulcer disease. H2 blockers include:

Proton Pump Inhibitors
Also known as proton pump inhibitors (PPIs), these completely block acid production in the stomach. Doctors prescribe Proton Pump Inhibitors to treat people with GERD, ulcers of the stomach or intestine, or other digestive disorders that may cause excess stomach acid. Proton Pump Inhibitors include:

Sources:

"Barrett's Esophagus" NIH Publication No. 05–4546 December 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 26 Mar 2008.

Ijeoma A. Azodo, Yvonne Romero, M.D.. "BARRETT'S ESOPHAGUS." American College of Gastroenterology. 26 Mar 2008.

Kenneth K. Wang, M.D. and Richard E. Sampliner, M.D., "Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett’s Esophagus." 2008;103:788–797. American Journal of Gastroenterology: Am. Coll. of Gastroenterology. 26 Mar 2008

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