Barbarona, Cyril Mae A.

BSN 3B
Barrett Esophagus
Barrett's esophagus is a condition in which tissue that is similar to the lining of your
intestine replaces the tissue lining your esophagus. People with Barrett's esophagus
may develop a rare cancer called esophageal adenocarcinoma. It is also a condition in
which the flat pink lining of the esophagus becomes damaged by acid reflux while
causes the lining to thicken and become red.
Etiology
The exact cause of Barrett esophagus isn’t known. But many people believed that it is a
long term complication of chronic gastroesophageal reflux disease. It is developed as a
result from irritation in the esophagus that develops after persistent contact with
stomach acid. Whether this acid reflux is accompanied by GERD symptoms or not,
stomach acid and chemicals wash back into the esophagus, damaging esophagus
tissue and triggering changes to the living of the swallowing tube, causing Barrett’s
Esophagus. Because of this damage, the lining becomes thick and red. There’s another
valve in between the esophagus and the stomach called the lower esophageal
sphincter. When it becomes damaged, gastroesophageal reflux disease (GERD)
happens. GERD triggers a change in this area, which becomes Barrett’s esophagus.
Although there’s a risk of developing cancer from Barrett’s, it’s tiny, and can be seen
early with regular checkups. If precancerous cells are detected, they can be treated
ASAP.
Risk factors
 Family history is one of the factor because genetics can increase your risk of
acquiring this disease.
 Male is more likely to have Barrett esophagus than woman because some men
are more drawn to alcoholic beverages than women.
 Age. It is more common on adults over 50 because esophageal swallowing
changes with aging.
 Chronic heartburn and acid reflux. Having GERD increase risk of having Barrett
esophagus because of its constant exposure of acid.
 Smoking can increase your risk to BE because nicotine can promote acid build
up that can trigger BE.
 Overweight. Body fat around your abdomen further increase your risk.
Pathophysiology
First the prolonged or frequent exposure to acid will lead to damage to the lining of
esophagus causing chronic esophagitis. The damaged areas will later on heal in a
metaplastic process. The abnormal columnar cells replace squamous cells and the
esophagus reddened causing difficulty swallowing and sore throat.
Diagnostic tools
Endoscopy is a test to look inside your body. A long, thin tube with a small camera
inside called an endoscope, is passed into your body through a natural opening such as
your mouth.
A biopsy is the removal of tissue from any part of the body to examine it for disease.
Some may remove a small tissue sample with a needle while others may surgically
remove a suspicious nodule or lump. Most needle biopsies are performed on an
outpatient basis with minimal preparation.
Management
Medical treatment
 Treat GERD by giving drug such as esomeprazole (Nexium), lansoprazole
(Prevacid), omeprazole (Prilosec)
 Periodic endoscopy to monitor the cells in your esophagus.
Pharmacological Management
Omeprazole, lansoprazole, pantoprazole and rabeprazole are proton pump inhibitor that
treat GERD and work by suppressing the stomach’s acid production. Less stomach acid
means less damage to the esophagus.
Nursing Diagnosis
Risk for Aspiration
Acute pain
Goal
To give patient precautionary measure in case of aspiration
To relieve patient’s pain in esophagus
Nursing Intervention
 Avoid placing patient in supine position, have the patient sit upright after meals.
 Avoid nasogastric intubation for more than 5 days.
 Instruct patient to chew food thoroughly and eat slowly
 Advise patient to have a healthy weight
 Eliminating foods and drinks that trigger heartburn
 Advise patient to stop smoking
Prognosis
If disease left untreated patient may develop adenocarcinoma.