Barrett's esophagus - Symptoms.

Barrett's esophagus itself has no specific clinical symptoms, which was established during dynamic observation of patients, and is very similar to GERD. In cases of successful therapy of GERD, it is usually possible to eliminate the complaints of patients and improve their condition, including eliminating endoscopic signs of reflux esophagitis, but the morphological signs and symptoms of Barrett's esophagus still remain.

Clinical manifestations of GERD, the main ones being heartburn, pain behind the breastbone and/or in the epigastric region (in some patients these symptoms may be absent or only slightly expressed, especially in elderly and senile patients), regurgitation (in more severe cases - dysphagia), as well as less common symptoms associated with impaired motility of the upper gastrointestinal tract and/or with increased sensitivity of the stomach to stretching - a feeling of early satiety, distension, fullness in the epigastric region and others, often combined into a single term "discomfort", are caused not by Barrett's esophagus, but by GERD, the severity of which can vary.

Heartburn is considered the most frequent, even obligatory symptom of GERD. The Guidelines from the Genval Conference, published in 1999, noted that "heartburn is the most frequent symptom of reflux disease, occurring in at least 75% of patients." Heartburn (burning) is a possible non-specific response of the human body to various influences (acid, pancreatic enzymes, bile acids, mechanical and chemical influences, etc.), to a certain extent depending on the duration and intensity of one or a combination of these factors.

In principle, when considering heartburn and burning behind the breastbone as symptoms of Barrett's esophagus, the following should be noted: the frequency, severity and duration of heartburn vary quite a bit among different people; the severity of heartburn largely depends not only on the above factors, but also on the sensitivity of a particular person's esophagus to mechanical (stretching, pressure) and chemical irritation, including, in some people, to the consumption of certain foods and liquids (directly during or immediately after ingestion), as well as cigarette smoking; with increasing age, the sensitivity of the esophagus to the effects of various factors decreases (this fact is probably mainly due to a decrease in the acidity of the gastric contents periodically entering the esophagus); the proposed and/or suggested criteria for assessing heartburn (severity and frequency of occurrence) for GERD and its relationship with the development of the disease are quite arbitrary; Obviously, for some diseases, significant suppression of hydrochloric acid secretion during treatment of patients is necessary for a relatively long period of time, while for other diseases, a short period of time is quite sufficient. For example, when treating non-ulcer functional dyspepsia, 1-2 weeks are sufficient; then other factors become more important in treating patients. It should be noted that the occurrence of heartburn behind the breastbone and/or in the epigastric region is often perceived by patients as the appearance of pain, which must be taken into account during examination.

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