Barrett's esophagus is a condition where the lining of the esophagus is replaced by intestinal-type cells due to chronic acid reflux. It increases the risk of esophageal adenocarcinoma. Diagnosis is typically made during endoscopy by identifying changes in esophageal cell type beyond the gastroesophageal junction. Treatment focuses on minimizing acid reflux through lifestyle changes and medications, with additional procedures used in cases of dysplasia to remove abnormal cells and further reduce cancer risk.
Colorectal cancer is most common GI cancer
The rectum is the most frequent site involved
Adenoma-carcinoma sequence: Arises from adenoma in stepwise progression
Colorectal cancer is most common GI cancer
The rectum is the most frequent site involved
Adenoma-carcinoma sequence: Arises from adenoma in stepwise progression
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
Please find the power point on Carcinoma of rectum. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
Congenital absence of anal opening can happen both in male and female babies. Since they can't pass stool, this is a neonatal emergency surgical problem. Exact type of anomaly should be ascertained and appropriate surgical correction should be done precisely.
Barrett's esophagus is a condition in which the tissue lining the esophagus—the muscular tube that connects the mouth to the stomach—is replaced by tissue that is similar to the lining of the intestine. This process is called intestinal metaplasia.
No signs or symptoms are associated with Barrett's esophagus, but it is commonly found in people with gastroesophageal reflux disease (GERD). A small number of people with Barrett's esophagus develop a rare but often deadly type of cancer of the esophagus.
Barrett's esophagus affects about 1 percent1 of adults in the United States. The average age at diagnosis is 50, but determining when the problem started is usually difficult. Men develop Barrett's esophagus twice as often as women, and Caucasian men are affected more frequently than men of other races. Barrett's esophagus is uncommon in children.
The EsophagusThe esophagus carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids into the intestine, which then absorbs needed nutrients. This process is automatic and people are usually not aware of it. People sometimes feel their esophagus when they swallow something too large, try to eat too quickly, or drink very hot or cold liquids.
Digestive tract.
The muscular layers of the esophagus are normally pinched together at both the upper and lower ends by muscles called sphincters. When a person swallows, the sphincters relax to allow food or drink to pass from the mouth into the stomach. The muscles then close rapidly to prevent the food or drink from leaking out of the stomach back into the esophagus and mouth.
NIDDK
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
Please find the power point on Carcinoma of rectum. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
Congenital absence of anal opening can happen both in male and female babies. Since they can't pass stool, this is a neonatal emergency surgical problem. Exact type of anomaly should be ascertained and appropriate surgical correction should be done precisely.
Barrett's esophagus is a condition in which the tissue lining the esophagus—the muscular tube that connects the mouth to the stomach—is replaced by tissue that is similar to the lining of the intestine. This process is called intestinal metaplasia.
No signs or symptoms are associated with Barrett's esophagus, but it is commonly found in people with gastroesophageal reflux disease (GERD). A small number of people with Barrett's esophagus develop a rare but often deadly type of cancer of the esophagus.
Barrett's esophagus affects about 1 percent1 of adults in the United States. The average age at diagnosis is 50, but determining when the problem started is usually difficult. Men develop Barrett's esophagus twice as often as women, and Caucasian men are affected more frequently than men of other races. Barrett's esophagus is uncommon in children.
The EsophagusThe esophagus carries food and liquids from the mouth to the stomach. The stomach slowly pumps the food and liquids into the intestine, which then absorbs needed nutrients. This process is automatic and people are usually not aware of it. People sometimes feel their esophagus when they swallow something too large, try to eat too quickly, or drink very hot or cold liquids.
Digestive tract.
The muscular layers of the esophagus are normally pinched together at both the upper and lower ends by muscles called sphincters. When a person swallows, the sphincters relax to allow food or drink to pass from the mouth into the stomach. The muscles then close rapidly to prevent the food or drink from leaking out of the stomach back into the esophagus and mouth.
NIDDK
A motivational Presentation for my college course. It is supposed to have music and video already in it, but I guess Slideshare doesn't include them when uploading.
Gastro esophageal Reflux Disease (GERD) and its managementDr. Ankit Gaur
In this presentation I have tried to explain in brief about gastro esophageal Reflux Disease (GERD), its etiology, risk factors, diagnosis, and its management via pharmacotherapy.
Barrett's Esophagus is an acquired metaplastic condition in which healthy squamous epithelium is replaced by specialized intestinal columnar epithelium.
Occurs in 10-15% of patients with GERD. Prevalence of 0.9-10%(2%) in general adult population
Poor data in Africa because of absence of screening programs
Dr Pravin John and Dr John Thanakumar, Anurag Hospital, Coimbatore present the differences between metabolic and obesity surgery - dept of advanced laparoscopy and obesity
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Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
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students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Biological screening of herbal drugs: Introduction and Need for
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Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
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2. What is Barrett’s Esophagus?
The esophagus gets a tissue
lining similar to that of the
intestines
The muscle becomes rougher
The cells that are normally
found in the intestine replace
the normal esophagus cells
3. Estimated prevalence of Barrett’s esophagus
6-12% of patients who undergo EGD for GERD.
Short-segment BE: 6-12%
Long-segment BE: 1-5%
1-2% of unselected patients who undergo EGD
Most cases go undetected in the general
population [Autopsy data]. Perhaps 5% of patients
with Barret esophagus are currently being
diagnosed.
4. Symptoms of Barretts esophagus
There are no specific
symptoms, they vary per
person
Some signs it is likely include:
Constant acid reflux
Burning sensations near chest
bone
Pain in throat and chest when
eating
5. frequent and longstanding heartburn
trouble swallowing (dysphagia)
vomiting blood (hematemesis)
pain under the breastbone where the esophagus meets
the stomach
unintentional weight loss because eating is painful
6. Risk factors for development
of Barrett’s esophagus
Male gender 3 times > female gender
White race >> Blacks & Asians
Abdominal adiposity (obesity)
Genetic factors suspected in some patients/families
Chronic reflux symptoms for > 5-10 years
Age >40-50 years; mean age at diagnosis = 55 yrs
7. Mechanism
Barrett esophagus occurs due to chronic
inflammation. The principal cause of the chronic
inflammation is gastroesophageal reflux disease,
GERD . In this disease, acidic stomach, bile, small
intestine and pancreatic contents cause damage to the
cells of the lower esophagus
8. Damage to the squamous
esophageal mucosa
Injury heals
through a metaplastic process
(columnar cells replace squamous cells)
Pathogenesis of Barrett’s Esophagus
GERD
Injury heals
with restoration of
squamous mucosa
9. Long-segment versus
short-segment Barrett’s esophagus
Long-segment BE (LSBE): >3-cm segment of distal esophagus (columnar
mucosa with intestinal metaplasia)
Short-segment BE (SSBE): <3-cm segment (usually tongues or islands of
columnar mucosa with intestinal metaplasia)
Patients with LSBE tend to have greater esophageal acid exposure than
SSBE, as well as lower LES pressures and more esophageal dysmotility.
LSBE (classic BE) is much better studied.
We are currently managing LSBE and SSBE similarly.
However, questions remain:
Does SSBE have the same pathogenesis?
Does SSBE have a lower risk of cancer?
Does SSBE progress to LSBE?
Does the length of BE correlate with cancer risk?
11. Physiology of Barrett’s
Esophagus
When food becomes backed
up, the juices of the stomach
go back up the esophagus.
This is also known as severe
acid reflux.
When having a repeated
injury to the Esophagus
, acidic fluid changes the
types of cells lining it from
squamous to columnar
.(METAPLASIA)
Fluid may contain bile acids.
12. Development of Neoplasia in Barrett’s
Esophagus
1
2Gastric acid reflux
2
1Duodenal bile reflux
Pro-carcinogenic
primary and
secondary bile salts
3
pH dependent,bile
salt induced chronic
esophageal injury
4
Chronic esophageal
inflammation and
PGE2release
5
Neoplasia in Barrett’s
esophagus
13. Development of esophageal adenocarcinoma from
Barrett’s esophagus
Compelling evidence exists for a dysplasia-carcinoma
sequence in BE.
Specialized columnar epithelium progresses in some patients
→ low-grade dysplasia → high-grade dysplasia →
adenocarcinoma.
Not every patient with low-grade dysplasia progresses, and
low-grade dysplasia can even spontaneously revert back to
no dysplasia.
Time course for development of cancer highly variable.
Most patients never progress to dysplasia. Less than 5% of
Barrett’s patients will develop cancer.
14. Why do we care about Barrett’s esophagus?
Patients with BE have an increased risk of developing esophageal
adenocarcinoma.
Over the past 30 years, the incidence of squamous cell cancer of the
esophagus has stayed constant, while the incidence of adenocarcinoma
has increased 6-fold! This is an increase that exceeds that of any other
cancer.
Today, adenocarcinoma accounts for more than half of esophageal
cancers.
Patients with BE have about a 30-40 fold increased risk of
adenocarcinoma of esophagus.
Risk of a BE patient developing cancer is estimated to be about 1 per
200 patient-years follow-up.
Despite all this, most patients with BE do not develop esophageal
cancer. [Less than 5%]
15. Diagnosis
GERD is a precursor to the
diagnosis of Barrett’s
Esophagus.
The tissue lining of the
esophagus has changed.
Endoscopy (a long thin tube
that examines the lining of
the esophagus and stomach)
confirms whether or not cells
are abnormal.
16. 1. Locate gastro-
esophageal
junction
3. Describe extent of
metaplasia
consistently
2. Recognize the
squamocolumnar
junction
Three Essential Steps for
Endoscopic Diagnosis and
Description
17. Therapy of Barrett’s Esophagus
Antisecretory therapy
Surgery
Ablation
Chemoprevention
18. TREATMENT AND
MANAGEMENT TACTICS
TREATMENT OF the mai cause that is GERD-
Treatment should improve acid reflux symptoms, and
may keep Barrett's esophagus from getting worse.
Treatment may involve lifestyle changes and
medications such as:
Antacids after meals and at bedtime
Histamine H2 receptor blockers(viz rantidine
famotidine etc)
Proton pump inhibitors(pantoprazole,lansoprazole
etc)
19. N.B.- Lifestyle changes, medications, and anti-
reflux
surgery may help with symptoms of GERD, but will
not
make Barrett's esophagus go away.
20. TREATMENT OF BARRETT'S ESOPHAGUS
Surgery or other procedures may be recommended if a
biopsy shows cell changes that are very likely to lead to
cancer. Such changes are called severe or high-grade
dysplasia.
21. Surgery
Removal of intestinal
cells from esophagus and
replacement of
esophageal cells
Removal of the
esophagus
22. Recent advance in surgical
method
Photodynamic therapy (PDT) uses a special laser
device, called an esophageal balloon, along with a drug
called Photofrin.
Other procedures use different types of high energy to
destroy the precancerous tissue.
Surgery removes the abnormal lining.
23. Fun and Interesting Facts
Only about 1% of all Americans suffer from Barret’s
Esophagus
10% to 15% of people with chronic GERD get Barrett’s
Esophagus.
About 3.3 million adults over 50 years of age in the United
States have Barrett’s Esophagus.
Men are more likely to develop Barrett’s Esophagus than
women and the ratio is 2:1, and EUROPEAN males are
more likely to have it than any other race.