New treatment for common digestive condition Barrett's esophagus
- Date:
- April 14, 2015
- Source:
- University of Warwick
- Summary:
- New research could transform treatments and diagnosis for a common digestive condition which affects thousands of patients.
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New research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust could transform treatments and diagnosis for a common digestive condition which affects thousands of patients.
The esophagus or food pipe (gullet) is part of the digestive system. It is the tube that carries food from your mouth to your stomach. Barrett's esophagus (also known as BE) and low-grade dysplasia affects approximately 2% of the adult population, particularly those with heartburn, as acid reflux from the stomach can, over time, damage the lining of the esophagus and lead to BE. BE is seen in people undergoing endoscopy to determine the cause of their digestive problems. Barrett's esophagus can sometimes lead to cancer.
The team of researchers from Warwick Medical School, UHCW NHS Trust and Coventry University's Centre for Technology Enabled Health Research found that invasive procedures are often not the best option to treat and diagnose patients suffering from Barrett's esophagus.
Publishing their findings in the American Journal of Gastroenterology, the researchers looked at a wide range of studies about this condition.
Patients are currently commonly offered surgery for pre-cancerous changes in BE. However, the researchers found that in most cases, medical therapies and continuous monitoring are more effective to identify and prevent cancer for patients than surgery.
Where patients had a more advanced form of the condition, however, the team found that endoscopic resection surgery was the best option.
The team also recommended that men over 60 who had suffered gastro-esophageal reflux disease (GORD) for ten years or over should be screened for Barrett's esophagus.
The researchers have developed a new definition of BE to standardise diagnosis of the condition for clinicians in the USA and Europe. The team has also proposed a clear plan for treating patients depending on how their condition develops.
The world-leading study is believed to be one of the largest reviews of this kind in internal medicine. The team reviewed 20,300 papers by over 100 world experts.
Professor Janusz Jankowski, Professor of Acute Medicine at Warwick Medical School and UHCW NHS Trust, said: "This paper could have huge implications for the thousands of patients diagnosed with Barrett's esophagus. We hope that our findings will transform care for patients, and also help to identify patients at risk of developing cancer at the earliest possible opportunity."
Professor Cathy Bennett, Professor in Systematic Reviews, at Coventry University, said: "We created a unique opportunity for doctors and scientists from around the world to work together. We used a specially designed web-based platform to interact, discuss and summarise the vast amount of medical evidence available for the management of this condition.
"As a result of our work, healthcare professionals from all parts of the world will be able to access these new key recommendations"
The group now plans to look at genetic markers for BE patients, to determine the risk of patients going on to develop cancer.
About Barrett's esophagus
Barrett's esophagus is a common condition affecting the digestive system, which is commonly linked to long-term gastro-esophageal reflux disease (GORD).
The average age at diagnosis is 62, and it is a pre-cancerous condition, meaning that a small number of patients go on to develop esophageal cancer.
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Materials provided by University of Warwick. Note: Content may be edited for style and length.
Journal Reference:
- Cathy Bennett, Paul Moayyedi, Douglas A Corley, John DeCaestecker, Yngve Falck-Ytter, Gary Falk, Nimish Vakil, Scott Sanders, Michael Vieth, John Inadomi, David Aldulaimi, Khek-Yu Ho, Robert Odze, Stephen J Meltzer, Eamonn Quigley, Stuart Gittens, Peter Watson, Giovanni Zaninotto, Prasad G Iyer, Leo Alexandre, Yeng Ang, James Callaghan, Rebecca Harrison, Rajvinder Singh, Pradeep Bhandari, Raf Bisschops, Bita Geramizadeh, Philip Kaye, Sheila Krishnadath, M Brian Fennerty, Hendrik Manner, Katie S Nason, Oliver Pech, Vani Konda, Krish Ragunath, Imdadur Rahman, Yvonne Romero, Richard Sampliner, Peter D Siersema, Jan Tack, Tony C K Tham, Nigel Trudgill, David S Weinberg, Jean Wang, Kenneth Wang, Jennie Y Y Wong, Stephen Attwood, Peter Malfertheiner, David MacDonald, Hugh Barr, Mark K Ferguson, Janusz Jankowski, Shahab Abid, Chris Abley, Haythem Ali, William Allum, Max Almond, David Armstrong, Rami Badreddine, Adrian Bateman, Shobna Bhatia, Luigi Bonavina, Serhat Bor, David Bunting, Brooks Cash, Ivan Cecconello, Gianpaolo Cengia, Renzo Cestari, Amitabh Chak, Gareth Davies, Xavier Benoit D'journo, Kerry B Dunbar, Christian Ell, Emad El-Omar, Laszlo Fonyad, Alexander Ford, Grant Fullarton, James Going, Susi Green, Nalini Guda, Christine Hachem, Stephen Heller, David Hewin, Juergen Hochberger, Brenda Hoffman, Michio Hongo, Farhad Islami, David Johnston, Hwoon-Yong Jung, Kee Wook Jung, Peter Kahrilas, Yoshikazu Kinoshita, Ernst Kuipers, Juozas Kupcinskas, Toni Lerut, Paul Limburg, Duncan Loft, Gaius Longcroft-Wheaton, Maurice Loughrey, Reza Malekzadeh, Tomas Marek, Shahab Abid, Michal Mazurkiewicz-Soldek, Hiroto Miwa, Fouad Moawad, Mindy Mintz Mordecai, Humayun Muhammed, Helmut Neumann, Praful Patel, Deepa Patil, Marco G Patti, Raymond Playford, David Poller, Hans Prenen, Sean Preston, Michael Quante, Vivien Rolfe, Jaroslaw Regula, Thomas Rice, Thomas Schnell, Prateek Sharma, Rhonda F Souza, Hubert Stein, Robert Stuart, Nicholas Talley, William Tam, Ghias Tayyab, George Triadafilopoulos, Vincenzo Villanacci, Shahjehan Wajed, Irving Waxman, Roy K H Wong. BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia. The American Journal of Gastroenterology, 2015; DOI: 10.1038/ajg.2015.55
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