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Symptoms of Barrett's esophagus
Last reviewed: 23.04.2024
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Barrett's esophagus does not have a specific pattern. As a rule, the diagnosis is established by the results of endoscopic screening and histological findings. At the same time, most children with Barrett's esophagus present complaints typical of GERD: heartburn, belching, regurgitation, loneliness, less often dysphagia. Some children have a "symptom of a wet pillow".
In a number of cases, the diagnosis of GERD is established after a detailed study of the characteristics of its extra-esophageal manifestations or complications. In particular, the atypical course of bronchial asthma, which does not have a clear atopic underlying tissue for treatment, allows one to suspect a GER-dependent variant of the disease.
One of the causes of posthemorrhagic iron deficiency anemia in children is a sliding hernia of the esophageal opening of the diaphragm - a factor potentially contributing to the development of Barrett's esophagus. There are many cases where the manifestation of the hematological symptoms allowed to suspect and confirm the disease of the esophagus and cardia.
Other extra-oesophageal manifestations of GERD in children (otorhinolaryngological, cardiological, dental) are much less common.
At the same time, there is evidence that about one in four adult patients with Barrett's esophagus have 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, it is less sensitive to various kinds of mechanical influences. In this connection, however, the origin of the symptoms (including pain) in the remaining 75% of patients is not entirely clear.
A great deal of attention is paid to the problem of H. Pylori (Hp) in recent years. If the role of this microorganism in the genesis of a number of diseases of the gastroduodenal zone is sufficiently well studied, then studies of the significance of Hp infection for esophageal pathology are very few and contradictory.
Some authors indicate the possibility of GERD with de novo esophagitis after Hp eradication, for example, for ulcer disease. Other authors come up with exactly the opposite results. There are data on the possibility of colonization of Hp on the metaplastic epithelium of Barrett, which probably increases its precancerous potential. From the foregoing, it can be concluded that the association of Hp infection and Barrett's esophagus is currently insufficiently studied, especially in pediatrics.
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