Definition
Barrett's esophagus is a precancerous disease that affects the esophagus, sometimes damaging it permanently: due to repeated acid insults, the normal tissue lining the esophagus is replaced by an epithelium similar to that of the duodenal walls (metaplasia of the esophageal epithelium).
Causes
Barrett's esophagus is the most fearful complication of esophagitis and gastroesophageal reflux disease in general: the continuous ascent of acidic gastric juice from the stomach to the esophagus can generate an increasingly severe erosion, irreversibly modifying the esophageal epithelium until it degenerates into Barret's disease.
Other risk factors for Barret's esophagus: alcoholism, hiatal hernia, advanced age, obesity / overweight, genetic predisposition, male sex, smoking.
Symptoms
The typical symptoms of Barret's esophagus are almost the same as those of gastroesophageal reflux disease: back sternal burning, dysphagia, frequent regurgitation up to the mouth, pharyngitis, blackish stools with blood (borderline cases), chronic inflammation of the vocal cords, ulcerative lesions in the last part of the esophagus, gastric heartburn and odynophagia.
The information on Barrett's Esophagus - Medicines to Treat Barret's Esophagus is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Barrett's Esophagus - Medicines for the Barret's Esophagus Care.
Medicines
In addition to treating Barrett's esophagus, drugs are aimed at controlling the typical symptoms of gastroesophageal reflux: in any case, the main objective is to restore the physiological squamous epithelium of the esophagus, modified by the progressive corrosion of the wall cells. :
N.B. in case of lack of dysplasia, drug therapy to treat Barrett's esophagus is the same as for gastroesophageal reflux disease
Proton pump inhibitors: they are able to reduce gastric acidity, responsible for the irritation of the mucous membrane of the esophagus and stomach.
- Dexlansoprazole (eg. Dexilant): in case of erosive esophagitis, we recommend an initial administration of 60 mg per day for 8 weeks, and then continue with maintenance therapy by taking 30 mg of active ingredient per day for six months. In this way, Barrett's esophagus, the most dangerous complication, is prevented. Similarly, in the case of gastroesophageal reflux disease with possible degeneration in Barrett's esophagus, the administration of 30 mg of active ingredient once a day is recommended. for 4 weeks.
- Esomeprazole (eg Lucen, Nexium): it is recommended to take orally 30 mg of the drug per day for 8 weeks; alternatively, parenterally administer 30 mg of active ingredient for 7 days (duration of infusion: 30 minutes). Useful for the prevention of Barrett's esophagus.
- Pantoprazole (eg. Peptazol, Pantorc, Nolpaza, Gastroloc): this drug is also recommended to control the symptoms of gastroesophageal reflux, in order to avoid a possible degeneration in Barrett's esophagus. In this sense, administer 40 mg of active ingredient per day for a period ranging from 7 to 10 days (intravenously for a period of 15 minutes). If the patient is able to swallow, the drug can also be taken orally (40 mg for 8 weeks).
Histamine H2-receptor antagonist
Histamine, by binding to the H2 receptors, stimulates the proton pump by activating the adenylate cyclase. By preventing this stimulus on the proton pump, the drug prevents the formation of HCl
- Nizatidine (eg Nizax, Cronizat, Zanizal): a dose of 150 mg of active ingredient twice a day is recommended. For children who have already turned one year and suffering from gastroesophageal reflux diseases, it is recommended to administer 10mg / kg per day, divided into two doses, for 8 weeks. If the child is between the ages of 4 and 11, the recommended dose drops to 6 mg / kg per day, divided into two doses. Administration of the drug is recommended to prevent degeneration of the esophageal epithelium: this drug , by decreasing the acidity of gastric juices, it avoids the worsening of symptoms and, at the same time, is useful in the prophylaxis of metaplasia of the esophageal wall.
Eventually, in case of vomiting associated with Barrett's esophagus, the doctor may prescribe antiemetics, to avoid worsening the clinical picture. The drug must be determined by the doctor, based on the severity of the patient's problem.
Alternative therapies to cure Barrett's esophagus
When Barrett's esophagus is characterized by dysplasia (even minor), drug therapy is not sufficient; therefore it is necessary to resort to alternative therapies (based on the severity of the problem):
- surgical removal of the abnormal tissue
- laser
- radiofrequency ablation
- removal of damaged tissue with endoscopic instruments
- photodynamic therapy
- Removal of the entire portion affected by Barrett's esophagus (and subsequent seaming of the remaining portion with the mouth of the gastric cavity)
Other articles on "Barrett's Esophagus - Drugs to Treat" Barret's Esophagus "
- Barrett's esophagus
- Esophagitis
- Esophagitis: diagnosis and treatment
- Medicines for the treatment of esophagitis
- Diet for esophagitis
