Transcript Slide 1 - LIFE at UCF

Welcome!
Esophageal Health,
Acid Reflux, Barrett’s and
Cancer
Philip N Styne, MD AGAF
Medical Director
Digestive Health Center
Upper GI tract
Function of upper
GI anatomy
• Esophagus - passes food and fluid
from mouth to stomach
• Stomach - mechanical and
enzymatic digestion
Function of upper
GI anatomy
• Pancreas & liver - digestive
enzymes and detergents
• Small intestine - absorbs salts,
vitamins, minerals and food
Gastroesophageal
Reflux
• Abnormal return of food, fluid,
acid and digestive enzymes into
the esophagus.
Gastroesophageal
Reflux
• Acid has both digestive and
protective role
• Lining of the esophagus does not
make acid, has no barrier to acid
exposure
• Lining of stomach makes acid and
has its own acid barrier
Gastroesophageal
Reflux
• Esophagogastric junction three-
part system to control reflux of
gastric contents into the esophagus
Gastroesophageal
Reflux
Reflux results in:
• Heartburn
• Inflammation
• Stricture
• Barrett’s Esophagus
• Asthma, cough, throat clearing
and hoarseness
Lifestyle Changes
• Nutrition
• What, when & how much?
• Diets consisting mainly of green
and yellow vegetables
• Small meals
• Nothing to eat for 3 hours
before bedtime
Lifestyle Changes
• Diet
• Maintaining a healthy weight
• Low fat meals
• Limited alcohol
• No tobacco products
Lifestyle Changes
• Walking after evening meal for
20 minutes
• Elevation of the head of the
bed
Medication
• Acid reduction reduces
symptoms and esophageal
inflammation
• Antacids
• H2RA
• PPI
• Prokinetics
Barrett’s Esophagus
• Result of reflux
• Precursor of Esophageal Cancer
• Predictable changes before Cancer
• Treatable with endoscopic procedure
Barrett’s Esophagus
Due to chronic reflux:
• Risk of cancer
• Adenocarcinoma which is associated
with Barrett’s is the fastest increasing
gastrointestinal cancer.
Esophageal Cancer
• Fastest rising rate of all
gastrointestinal cancers.
• The cancer associated with
Barrett’s Esophagus has
increased over 400%.
Our Goal:
• Prevent cancer morbidity
and mortality.
• Reduce occurrence and find
earlier more curable stage.
Endoscopy
• Allows evaluation of the
lining of the upper-intestinal
tract
• Allows for biopsy of the
esophagus
Endoscopy
Endoscopy
Endoscopy
Normal Esophagus
Barrett’s Esophagus
Acid Reflux
Esophageal Cancer
Ulcers & Itis
• Barrier breakers result in
inflammation of stomach and
duodenum including ulcers
• ASA\NSAID\Cox 2 inhibitor
have the ability to affect gastric
acid barrier
• Helicobacter pylori
Ulcers & Itis
• Small intestine disease
• Celiac sprue, gluten sensitivity
• Lactose intolerance
• Other carbohydrate malabsorption
• Giardia
• Bacterial overgrowth
Questions?
For more information visit:
www.FHDigestive.com
Information sheets and priority
appointments available.