Authors:
Muhammad Miftahussurur
;
Iswan Abbas Nusi
;
Poernomo Boedi Setiawan
;
Herry Purbayu
;
Titong Sugihartono
;
Ummi Maimunah
;
Ulfa Kholili
;
Budi Widodo
;
Husin Thamrin
and
Amie Vidyani
Affiliation:
Department of Internal Medicine, Faculty of medicine Universitas Airlangga, Dr. Soetomo General Hospital and Surabaya, Indonesia
Keyword(s):
Barrett's esophagus, squamocolumnar, gastroesophageal, intestinal metaplasia, gastroesophageal reflux disease
Abstract:
Barrett's esophagus (BE) is a displacement of the squamocolumnar border (SCJ) site to proximal to the gastroesophageal junction (GEJ) accompanied by the presence of intestinal metaplasia. BE develops when reflux-induced stomach acid destroys the squamous epithelial layer of the esophagus and this lesion heals via a metaplasia process in which the damaged squamous epithelial layer is replaced by columnar colon-type epithelium. BE prevalence in the general population is about 1.6-1.7%. Patients with gastroesophageal reflux disease (GERD) may progress to BE. This report concerns two cases of patients with Barrett's esophagus. In both these patients BE was found without dysplasia. A diagnosis was made on the basis of anamnesis, physical examination, laboratory, radiological, endoscopy and anatomical pathology. The management of BE is aimed at three main objectives: reduction of symptoms due to GERD, avoiding progression to strictures and ulcers, and preventing progression to adenocarcino
ma. Both patients were given a PPI, a prokinetic and chemoprevention NSAID which achieved clinical improvement. Neither patient had ablation, photodynamic or mucosal resection. BE survival is much better than in groups without BE (5 years survival 61% vs. 28%, P = 0.001)
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