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Symptoms of Barrett's esophagus
Last reviewed: 06.07.2025
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Barrett's esophagus does not have a specific picture. As a rule, the diagnosis is established based on the results of endoscopic screening and histological findings. However, most children with Barrett's esophagus present complaints typical of GERD: heartburn, belching, regurgitation, odynophagia, and less often dysphagia. Some children have a "wet pillow symptom".
In some cases, the diagnosis of GERD is established after a detailed study of the characteristics of its extraesophageal manifestations or complications. In particular, the atypical course of bronchial asthma, which does not have a clear atopic background and is torpid to treatment, allows one to suspect a GER-dependent variant of this disease.
One of the causes of posthemorrhagic iron deficiency anemia in children is a sliding hernia of the esophageal orifice of the diaphragm - a factor potentially contributing to the development of Barrett's esophagus. There are many known cases when the manifestation of hematological symptoms allowed us to suspect and confirm the disease of the esophagus and cardia.
Other extraesophageal manifestations of GERD in children (otolaryngological, cardiological, dental) are much less common.
At the same time, there is data that approximately every fourth adult patient with Barrett's esophagus has no complaints from the esophagus. This fact is explained by the fact that atypical cylindrical epithelium in the esophagus not only does not give a specific clinical picture, but, on the contrary, is less sensitive to various types of mechanical effects. In this regard, however, the origin of symptoms (including pain) in the remaining 75% of patients is not entirely clear.
Much attention in the works of recent years is paid to the problem of H.pylori (Hp). If the role of this microorganism in the genesis of a number of diseases of the gastroduodenal zone has been studied well enough, then studies of the significance of Hp infection for esophageal pathology are very few and contradictory.
Some authors point to the possibility of GERD with de novo esophagitis after Hp eradication, for example, for peptic ulcer disease. Other authors come up with directly opposite results. There is evidence of the possibility of Hp colonization on Barrett's metaplastic epithelium, which probably increases its precancerous potential. From all of the above, it can be concluded that the relationship between Hp infection and Barrett's esophagus is currently insufficiently studied, especially in pediatrics.
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