Barrett's esophagus

Right.

And one of the big concerns is cancer of the esophagus or the potential precursor, which is called Barrett's esophagus.

Yes.

So, you know, if, I mean, not that I would want to have dementia or osteoporosis, but I think that, you know, I wanna have a good quality of life.

Peptic refers to acid or the stomach.

Mm-hmm.

And then finally, if they had evidence of Barrett's esophagus, these would be the endoscopic ways that we could make a diagnosis of GERD.

Right, an endoscopy for everyone is the-

So it's just a change in the type of epithelium, right? So whereas, but as we know, the more cells change and the more they mutate, the higher likelihood of mutations to happen.

And that's why people with Barrett's are more likely to have esophageal adenocarcinoma.

Yeah.

Okay, great.

kind of thing.

That's good.

And then, so we've mentioned Barrett esophagus and esophageal adenocarcinoma.

What are some things you'd ask if you want to assess whether he has that or not?

Her father did have some kind of cancer, and it looks like esophagitis is only a small risk for this kind of cancer and that women are less likely to develop it opposed to men.

This expert says that most patients who have GERD and reflux esophagitis do not have Barrett's esophagitis, and most patients with Barrett's esophagitis do not develop cancer.

So esophagitis means your esophagus, the pipe where food and liquid goes down.

is inflamed, red, irritated, raw, usually from stomach acid.

Well, untreated acid reflux could potentially damage the lining of the esophagus.

And to protect itself, like to protect the lining, sometimes that lining will change into a tougher type of tissue.

We often call this Barrett's esophagus.

And in a small number of people, that Barrett's esophagus can slowly turn into cancer over time.

So cancers of the GE junction really are primarily related to acid reflux.

So we think that acid reflux, coming back up into the esophagus, creates a pre-malignant condition called Barrett's esophagus.

which then increases the risk for developing adenocarcinomas in those locations.

So the risk factor is really primarily acid reflux.

So that's exactly right.

So there's an intermediate step.

So again, there's a pre-milligan condition called Barrett's esophagus.

It actually has a characteristic appearance.

Right.

This is Barrett's esophagus.

And this is where the intricate design of the human body is so fascinating.

It swaps cell types to protect itself from the acid.

No, they don't.

The reflex of non-acidic gastric and biliary contents continues undebated, so we are heavily reliant on strict surveillance.

So for Barrett's with no dysplasia, we scope with four quadrant biopsies every three years.

And according to Sage's guidelines, this isolated finding is actually a strong indication for an anti-reflux procedure like a fundoplication to physically stop the chemical wash.

I have...

Barrett's Esophagus and GERD, which I've gone to.

There's a cancer center down here in Tampa.

And I started going to them about... maybe three years ago.