Top Docs: 5 facts about Barrett's esophagus

Dr. James H. Grendell, Chief, Division of Gastroenterology, Dr. James H. Grendell, Chief, Division of Gastroenterology, Hepatology & Nutrition at Winthrop University Hospital. Grendell is also a professor of medicine at SUNY Stony Brook's School of Medicine. (Nov. 27, 2012) Photo Credit: Newsday/Audrey C. Tiernan

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For many people, heartburn or acid reflux is an occasional nuisance. But for some, it's a more persistent problem, becoming what's known as gastroesophageal reflux disease, or GERD. That, in turn, can lead to a condition called Barrett's esophagus, which is a risk factor for esophageal cancer.

Here's what you need to know:

 

1. DON'T DISMISS CHRONIC HEARTBURN AS NOTHING TO WORRY ABOUT

 

Barrett's esophagus refers to a change in the cellular makeup of the lining of the esophagus. It's a problem because it's a sign that the person faces a higher risk for esophageal cancer.

"Although 'always' is difficult to prove, especially in medicine, Barrett's esophagus is typically the result of chronic injury to the lower esophagus by long-standing GERD," said Dr. James Grendell, chief of the division of gastroenterology, hepatology and nutrition at Winthrop-University Hospital in Mineola. "Risk factors for the development of Barrett's esophagus include being a white male over 50 years of age, GERD symptoms at least once a week for five or more years, presence of a hiatal upper stomach hernia and obesity," he said.

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2. BARRETT'S ESOPHAGUS IS A STEP ON THE ROAD TO CANCER

 

Grendell said that some people with Barrett's esophagus will develop a precancerous change in cells known as dysplasia. "Low-grade dysplasia occurs in about 5 percent of the patients," he said. "High-grade dysplasia is seen in about 2.5 percent of the patients and carries a risk of developing cancer of the esophagus of 4 to 5 percent per year."

Esophageal cancer is serious and one of the most rapidly increasing cancers in the Western world, said Dr. Robert Lazar, a gastroenterologist in Smithtown who's affiliated with St. Catherine of Siena Medical Center and North Shore Surgery Center.

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3. PROTON PUMP INHIBITOR MEDICATIONS ARE RECOMMENDED

 

Treatment with a proton pump inhibitor -- such as Prilosec and Prevacid -- may reduce symptoms of Barrett's esophagus, Grendell said, although it's rare that the condition completely goes away.

Lazar added that people can also try other approaches aimed at reducing acid in the stomach, such as changing their diet.

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4. SURGERY MAY BE AN OPTION

 

"In the past, if high-grade dysplasia or esophageal cancer limited to the surface of the inner lining of the esophagus was discovered during a screening endoscopy, the patient would be recommended to undergo surgical removal of the involved segment of the esophagus, a major operation that carries a significant risk of serious complications and even death," Grendell said. "Now these patients can often be treated with endoscopic techniques to either cut out or ablate the involved area, followed by lifelong treatment of GERD with a proton pump inhibitor medication."

However, he noted, "patients with cancer of the esophagus extending more deeply into the wall of the esophagus still require an operation to remove the involved segment of the esophagus if they are considered healthy enough to withstand the surgery."

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Lazar said that surgery is unlikely to reverse Barrett's esophagus. In general, he said, "once you have Barrett's esophagus, you have it."

 

 

5. REGULAR SCREENING IS KEY

 

"Patients with Barrett's esophagus and low-grade dysplasia require surveillance endoscopies with biopsies every 6 to 12 months," Grendell said. But anyone with chronic GERD symptoms should take precautions, too. "Patients with GERD symptoms occurring once a week or more should consult their doctors for advice on the treatment of GERD and for a recommendation concerning the need for endoscopic screening for Barrett's esophagus based on their specific risk factors," Grendell said.

 

 

Gastroenterologists

 

Dr. Robert S. Bartolomeo

1103 Stewart Ave., Ste. 300

Garden City

516-248-3737

Dr. David E. Bernstein

North Shore Univ. Hospital

Div. Gastroenterology

300 Community Dr.

Manhasset

516-562-4281

Dr. Meyer Blumstein

158 Hempstead Ave.

Lynbrook

516-593-3541

Dr. William Caccese

700 Old Country Rd., Ste. 104

Plainview

516-681-1200

Dr. Maurice A. Cerulli

270-05 76th Ave., Rm. B202

New Hyde Park

718-470-7281

Dr. William J. Cohn

3400 Nesconset Hwy.

Ste. 101

East Setauket

631-751-8700

Dr. Bethany S. DeVito

North Shore Univ. Hospital

4 Levitt Pavilion

300 Community Dr.

Manhasset

516-562-4281

Dr. Joseph M. Duva

887 Old Country Rd.

Ste. A

Riverhead

631-727-6122

Dr. David Eskreis

2001 Marcus Ave.

Ste. W85

Lake Success

516-326-2700

Dr. Charles Farber

146A Manetto Hill Rd.

Ste. 205

Plainview

516-822-4404

Dr. Barry Glanzman

152 E. Main St., Ste. C

Huntington

631-421-2185

Dr. Lester Goldblum

850 Hicksville Rd., Ste. 100

Seaford

516-796-9000

Dr. Ira S. Goldman

310 E. Shore Rd., Ste. 206

Great Neck

516-487-7677

Dr. Perry M. Gould

1103 Stewart Ave., Ste. 300

Garden City

516-248-3737

Dr. Ronald Greenberg

270-05 76th Ave., Rm. B 202

New Hyde Park

718-470-7281

Dr. James H. Grendell

222 Station Plaza N.

Ste. 428

Mineola

516-663-2066

Dr. Aaron R. Harrison

375 E. Main St., Ste. 21

Bay Shore

631-968-8288

Dr. Seymour Katz

1000 Northern Blvd.

Ste. 140

Great Neck

516-466-2340

Dr. Robert Lazar

48 Route 25A, Ste. 107

Smithtown

631-862-3680

Dr. Matthew McKinley

2800 Marcus Ave., Ste. 201

Lake Success

516-622-6076

Dr. Seth Miller

206 West Park Ave.

Long Beach; 516-432-8021

Dr. Perry J. Milman

2001 Marcus Ave., Ste. N18

Lake Success

516-775-7770

Dr. Gary Schwartz

1103 Stewart Ave., Ste. 300

Garden City

516-248-3737

Dr. Alan Spielberg

48 Route 25A, Ste. 203

Smithtown

631-724-1178

Dr. Arthur L. Talansky

233 E. Shore Rd., Ste. 101

Great Neck; 516-487-2444

Dr. Gary S. Weissman

2800 Marcus Ave., Ste. 201

Lake Success

516-622-6076

 

 

How they were picked

 

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/ nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.

 

 

To see the whole list . . .

 

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

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