TREATMENT
The Down With Acid ecyclopaedia covers these topics in more detail.
These pages may be removed from this site later.
Sub-pages:
Drugs - about the acid neutralising and reducing drugs prescribed or bought over the counter.
Surgical methods - Treatment options for Barrett's and GORD
Guidelines - The most recent guidelines from the British Society of Gastroenterologists regarding surveillance for Barrett's patients.
There can be confusion over medication and operations offered to Barrett's sufferers.
This page attempts to demystify the terms. The most common treatments are listed below. There are others not mentioned and newer treatments being developed all the time.
The oesophagus or gullet is the food pipe linking the throat to the stomach
(Americans spell it esophagus (without the initial 'o').)
Reflux is anything: acid, bile or stomach contents moving back up the oesophagus.
Heartburn is pain felt in the oesophagus from refluxing acid.
Not everyone feels the heartburn; this may be called silent reflux.
The Lower Oespohageal Sphincter (LOS) is a valve that should prevent reflux.
Antacids (such as Rennie) are usually calcium carbonate (chalk) based, chemically neutralising the acid and producing carbon dioxide (which may cause you to burp) and a harmless salt.
Alginates (such as Gaviscon) form a blanket over the stomach contents to prevent them refluxing.
Histamine H2 receptor antagonists (such as Ranitidine) block the production of stomach acid.
Proton Pump Inhibitors (such as Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole, Dexlansoprazole) reduce stomach acid more effectively.
Whilst removing the acid, drugs do not stop the reflux.
More information about the drugs may be found here.
This link will take you to the NHS management map for Barrett's Oesophagus.
Laparascopic Nissan Fundoplication is a keyhole operation in which the top part of the stomach is wrapped around the bottom of the oesophagus to tighten the lower oesophageal sphincter to reduce reflux.
Endoscopy is examination inside the body by a special camera on a long tube. When this is used to examine the oesophagus, it may be called Gastroscopy.
Biopsies are small cell samples cut away by the endoscopist for lab testing (histology).
Endoluminal Mucosal Resection (EMR) is a technique that may be used to remove discreet areas of Barrett's from the oesophagus.
With Photodynamic Therapy (PDT), the body is made extra sensitive to light with a drug and Barrett's Cells are burned away with a laser through an endocscope.
Argon Plasma Coagulation (APC) directs a jet of argon gas through an endoscope which is ionised (plasma) by a high voltage electrical discharge, burning away the cells.
Radio Frequency Ablation (formerly known as HALO) uses a special endoscope with a balloon to anchor the head against the wall of the oesophagus while a controlled burst of energy burns away the Barrett's cells.
Barrett's Oesophagus (intestinal metaplasia) develops as a defence against acid attack.
The normal pink (squamous) cells are replaced by red (columnar or intestinal) cells.
In some cases, Barrett's cells may undergo a further change called dysplasia which may be classed as low or high.
High Grade Dysplasia can further develop into "Oesophageal Adenocarcinoma" or cancer of the gullet, which is treated by an oesophagectomy - removing the oesophagus and attaching the stomach directly to the throat. Only about 15% of patients survive this.
The chances of Barrett's Oesophagus becoming cancerous are only around 0.3% per year and regular surveillance of those with Barrett's will spot pre-cancerous changes before it's too late.
A leaflet about the treatments available may be downloaded here.
The Encyclopaedia, Down With Acid, linked to by the tab above, is a comprehensive resource about acid, reflux, complicatios and management.