Barrett's Discussion

[daw]

A discussion was started about Barrett's at: http://forums.heartburn-help.com/showthread.php?s=&threadid=1172&perpage=10&pagenumber=1

This is a post of some Barrett's information and a continuation of that discussion .

"Plain" Barrett's is defined as the presence of (metaplastic) columnar epithelium cells in the esophagus. As you can see in the picture, Goblet cells are what determines whether or not you have intestinal metaplasia. The important thing to remember is that "metaplasia" is a PROCESS (see paragraph below). The process of cells changing. The grade of Dysplasia (which also has goblet cells because it arrises out of the process of intestinal metaplasia) is determined by how differentiated the cells become from normal cells (in the picture you can see how the cells start looking more and more like cancer cells as the dysplasia progresses).

http://pathology2.jhu.edu/beweb/cancer.cfm

"When the normal squamous lining cells of the esophagus are replaced by columnar cells, the process is known as metaplasia. Barrett's esophagus is a form of metaplasia. The metaplastic columnar lining comes in three types. Two types are similar to groups of cells found in regions of the stomach lining. The third type is similar to groups of cells found in the small intestine. This intestinal type of metaplasia is important because it can potentially lead to the development of cancer."

http://www.sts.org/doc/4490#1

[daw]

Found this posted on another GERD/Barrett's forum:

"Based on this article, since goblet cells define intestinal metaplasia, you can't have intestinal metaplasia without goblet cells."

"If intestinal metaplasia is present, defined by goblet cells seen
with combined hematoxylin and eosin-alcian blue pH 2.5 stains, the
patient is considered to have Barretts esophagus and should be placed
in a surveillance program. Biopsies of the squamocolumnar junction
should not be routinely obtained in clinical practice if it is at the
level of the gastroesophageal junction. Goblet cells found at this
level should be considered to be diagnostic of intestinal metaplasia
of the gastric cardia, a condition with an unclear cancer risk and
one in which cancer surveillance is not yet recommended."

http://www.clevelandclinic.org/gastro/barretts/medical/diagnosis.htm

Also some information on endoscopic surveillance of Barrett's:
http://www.clevelandclinic.org/gastro/barretts/medical/endoscopic.htm