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Barretts øsofagus

Sist revidert:
Sist revidert av:


Definisjon:
Premalign tilstand i distale øsofagus på bakgrunn av langvarig gastroøsofageal refluks
Forekomst:
Prevalens angis til 1-5%. Blant personer med reflukssykdom 5-15%
Symptomer:
De fleste har symptomer på reflukssykdom i form av sure oppstøt, halsbrann, sviende smerter i epigastriet - men noen er asymptomatiske
Funn:
Ingen kliniske funn knyttet til sykdommen
Diagnostikk:
Endoskopi og biopsi gir diagnosen
Behandling:
Medikamentell behandling med protonpumpehemmer, observasjon eller endoskopisk behandling
  1. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av spiserørskreft. Helsedirektoratet sist oppdatert 07.02.2020.
  2. Spechler SJ, Souza RF. Barrett's esophagus. N Engl J Med 2014; 371: 836-45. doi: 10.1056/NEJMra1314704 DOI  
  3. Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrret's esophagus in the general population: an endoscopic study. Gastroenterology 2005; 129: 1825-31. Gastroenterology  
  4. Ward EM, Wolfsen HC, Achem SR, et al. Barreet's esophagus is common in older men and women undergoing screening colonoscopy regardless of reflux-symptoms. Am J Gastroenterol 2006; 101: 12-7. PubMed  
  5. Westhoff B, Brotze S, Weston A, et al. The frequence of Barret's esophagus in high-risk patients with chronic GERD. Gastrointest Endosc 2005; 61: 226-31. PubMed  
  6. Jankowski J, Barr H, Wang K, Delaney B. Diagnosis and managmenet of Barrett's oesophagus. BMJ 2010; 341: c4551. BMJ (DOI)  
  7. Zimmerman TG. Common questions about Barrett esophagus. Am Fam Physician. 2014 Jan 15;89(2):92-8. PMID: 24444576. PubMed  
  8. Oslo universitetssykehus eHåndbok. Medisinsk fagprosedyre. Barrets øsofagus. Nettside besøkt 29.04.21. ehandboken.ous-hf.no  
  9. Spechler SJ. Barrett esophagus and risk of esophageal cancer: a clinical review. JAMA. 2013 Aug 14;310(6):627-36. PMID: 23942681 PubMed  
  10. Bhat S, Coleman HG, Yousef F, et al. Risk of malignant progression in Barret's esophagus patients: results from a large population-based study. J Natl Cancer Inst 2011; 103: 1049-57. PubMed  
  11. Hvid-Jensen F, Pedersen L, Drewes AM, et al. Incidence of adenocarcinoma among patients with Barrett's esophagus. N Engl J Med 2011; 365: 1375-83. New England Journal of Medicine  
  12. Bennett C, Moayyedi P, Corley DA, et al. BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett's Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia. Am J Gastroenterol. 2015 ;110:662-82; quiz 683. doi: 10.1038/ajg.2015.55 DOI  
  13. National Institute for Health and Clinical Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. Clinical guideline CG184. Last updated: 18 October 2019. www.nice.org.uk  
  14. Singh S, Garg SK, Singh PP, et al. Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus: a systematic review and meta-analysis. Gut. 2014 ;63(8):1229-37. doi: 10.1136/gutjnl-2013-305997 DOI  
  15. Sarna VK, Hauge, T. Barretts øsofagus. Indremedisineren 2021. indremedisineren.no  
  16. Sharma P. Barrett Esophagus: A Review. JAMA. 2022 Aug 16;328(7):663-671. PMID: 35972481 PubMed  
  17. Shaheen NJ, Falk GW, Iyer PG et al. Diagnosis and Management of Barrett's Esophagus: An Updated ACG Guideline. Am J Gastroenterol. 2022 Apr 1;117(4):559-587. PMID: 35354777.
  18. Wassenaar EB, Oelschlager BK. Effect of medical and surgical treatment of Barrett's metaplasia. World J Gastroenterol 2010; 16: 3773-9. PubMed  
  19. de Jonge PJ, Spaander MC, Bruno MJ, et al. Acid suppression and surgical therapy for Barrett's oesophagus. Best Pract Res Clin Gastroenterol. 2015;29:139-50. doi: 10.1016/j.bpg.2014.11.005 DOI  
  20. Jankowski JAZ, de Caestecker J, Love SB, et al. Esomeprazole and aspirin in Barrett's oesophagus (AspECT): a randomised factorial trial. Lancet. 2018 Aug 4;392(10145):400-408. doi: 10.1016/S0140-6736(18)31388-6. Epub 2018 Jul 26. (Original) PMID: 30057104 PubMed  
  • Silje Folven Barlindhaug, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Per Martin Kleveland, professor i gastroenterologi, Norges teknisk-naturvitenskapelige universitet og overlege gastroenterologisk avdeling St. Olavs Hospital, Trondheim