Barrett's Esophagus - Symptoms

Barrett's esophagus in itself does not have specific clinical symptoms that could be established with dynamic observation of patients, and very similar to GERD. In cases of successful therapy for GERD, it is usually possible to eliminate patient complaints and improve their condition, including eliminating the endoscopic signs of reflux esophagitis, but the morphological signs and symptoms of Barrett's esophagus still remain.

Clinical manifestations of GERD, the main of which are heartburn, chest pain and / or epigastric region (in some patients these symptoms may be absent or be negligible, especially in elderly and senile patients), regurgitation (in more severe cases, dysphagia) , as well as less common symptoms associated with impaired motor activity of the upper gastrointestinal tract and / or increased sensitivity of the stomach to stretching - a sense of early saturation, bursting, overflow in the epigastric t he area and others, are often combined into a single term "discomfort", caused not Barrett's esophagus, and GERD, which can be of varying severity.

Heartburn is considered as the most frequent, even mandatory symptom of GERD. The Guide to the results of the conference in Genval, published in 1999, noted that "heartburn is the most common symptom of reflux disease, which appears in at least 75% of patients." Heartburn (burning) is a possible nonspecific response of the human body to various effects (acid, pancreatic enzymes, bile acids, mechanical and chemical effects, etc.), depending to some extent on the duration and intensity of one or a combination of these factors.

In principle, considering the burning of the sternum and heartburn, as symptoms of Barrett's esophagus, it should be noted that the frequency of occurrence, severity and duration of heartburn are quite variable in different people; the severity of heartburn largely depends not only on the above factors, but also on the sensitivity of the esophagus of a particular person to mechanical (stretching, pressure) and chemical irritation, including in some individuals for the use of certain foods and liquids (already immediately during or immediately after taking), as well as smoking cigarettes; with increasing age, the sensitivity of the esophagus to the effect of various factors decreases (this fact is probably connected with a decrease in the level of acidity of the gastric contents that periodically enters the esophagus); the proposed and / or proposed criteria for assessing heartburn (severity and incidence) for GERD and its relationship to the development of the disease are rather arbitrary; it is obvious that for some diseases a significant suppression of the secretion of hydrochloric acid in the treatment of patients is necessary for a relatively long period of time, for other diseases it is quite sufficient for a short period of time. For example, when performing therapy for non-ulcerative functional dyspepsia, 1-2 weeks is sufficient; then other factors become more important in the treatment of patients. It should be noted that often the occurrence of heartburn after the sternum and / or in the epigastric region is perceived by patients as the appearance of pain, which must be taken into account in the examination.

[1], [2], [3], [4], [5]