Diseases of the Esophagus Fact Sheet

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Diseases of the Esophagus Fact Sheet
Esophageal Varices
 Varices are varicose veins that occur in the esophagus or stomach as a result of portal
hypertension, which is a symptom of cirrhosis (severe scarring of the liver). The
increased pressure within esophageal varices makes them susceptible to rupture and
 360 out of every 100,000 Americans have cirrhosis, and gastroesophageal varices are
present in 40-60% of cirrhotic patients.1
 Due to the high mortality rate (as high as 50%)1 associated with bleeding from
esophageal varices, screening of patients with cirrhosis for the presence of varices is
recommended by the American Association for the Study of Liver Diseases.2
 Treatment options include medical therapy aimed at decreasing portal pressure to
prevent variceal bleeding and endoscopic therapy for obliterating varices.
Gastrointestinal Reflux Disease
 Occurs when the lower esophageal sphincter (LES) muscle malfunctions or does not
close properly, and stomach acid leaks back into the esophagus, causing a burning
sensation in the chest or throat.3,4
 Complications of severe or chronic GERD include inflammation, ulcers, and bleeding
of the esophagus. Over time, scarring or narrowing (stricture) of the esophagus may
occur. A pre-cancerous condition, Barrett’s esophagus, may also develop as a
complication of GERD.5
 Over the course of a year, up to 60 percent of Americans will experience symptoms of
 More than 20 percent of Americans suffer from GERD symptoms on a weekly basis.6
 GERD is the third-most prevalent disease in the US with the highest annual direct
costs ($9.3 billion/year).7
 The American College of Gastroenterology (ACG) recommends screening men over
age 50 every three years, if they have a history of five years or more of chronic reflux
and reflux symptoms at least twice a week
Barrett’s Esophagus (BE)
 BE, a complication of GERD, is a pre-cancerous condition in which the lower portion of
the esophagus changes to abnormal cells that resemble normal cells found in the
 BE develops in about 10-20% of people with chronic GERD or inflammation of the
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Evaluating people with a history of GERD can help detect BE; 700,000 adults in the
U.S. are reported to have Barrett’s esophagus, which is twice as common in men. 9
The type of cancer that develops from BE is called esophageal adenocarcinoma.
A patient with BE has a 0.5% per year risk of developing esophageal
Esophageal Cancer
 There are two main types of esophageal cancer. Squamous cell carcinoma can occur
anywhere along the esophagus while adenocarcinoma starts at the opening of the
stomach and arises only from the cells of Barrett’s esophagus.
 More than 12,000 people develop esophageal cancer each year in the U.S.,8 and
about half of these cases are adenocarcinoma.10
 Barium contrast radiography or endoscopic ultrasonography may be used for
non-invasive detection of esophageal cancer. However, esophageal cancer is
ultimately diagnosed by endoscopy with biopsy.
Vargas H. Esophageal Capsule Endoscopy in evaluating varices in cirrhosis: current perspectives on screening. CME
program by Arc Mesa and InScope
2. Grace ND. Portal hypertension and variceal bleeding: An AASLD single topic symposium. Hepatology 1998;28:868-88
3. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd
4. http://www.acg.gi.org/patients/gerd/straight.asp#whatisgerd
5. http://www.gicure.com/pated/ecdgs39.htm Jackson Gastroenterology 423 North 21st street Suite 100 Camphill PA
6. Zhao, Y., and Encinosa, W. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005. HCUP
Statistical Brief #44. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcupus.ahrq.gov/reports/statbriefs/sb44.pdf
7. The burden of selected digestive diseases in the United States. Gastroenterology. 2002; 122:1500-11
8. John’s Hopkins Medical Institution Gastroenterology & Hepatology Resource Center http://hopkinsgi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease4&organ=2&disease=18&lang_id=1
9. Sampliner RE. Updated guidelines for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J
Gastroenterol 2002;97:1888-1895
10. American Cancer Society Webpage www.cancer.org/eprise/”how many people get esophagus cancer”
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