Medical Care |

Medical Care



This leaflet describes the various ways in which Barrett's Oesophagus is treated. There are two aimsin treating Barrett's Oesophagus: to relieve the symptoms of acid reflux and to prevent it developinginto cancer.
Treatment of acid reflux soon as you get symptoms.
People with Barrett's Oesophagus Rennies and Tums, and most of often have bad acid reflux but, the other medicines which you curiously, may have very few can buy over the counter, work in symptoms. The treatment for reflux in people with Barrett's Alginates also contain antacids Oesophagus is the same as for but, in addition, have a special people who do not have Barrett's.
ingredient which coats the lining There are three approaches: of the stomach and oesophagus. This barrier prevents the acid 1. Things you can do for yourself from breaching the area where it avoid eating large meals and would otherwise cause damage. avoid eating within two hours Gaviscon and Gastrocote are of going to bed.
examples of this class of medicine.
The following foods tend to make reflux symptoms worse: Acid suppression tablets work to chocolate, coffee, alcohol, fizzy stop acid being made before it can drinks, spicy foods, citrus.
cause damage. There are two types: histamine receptor However, lifestyle changes will antagonists like ranitidine (Zantac) only help about one in five who and proton pump inhibitors (PPIs) have the condition.
such as omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole. These PPIs are far Antacids immediately neutralise more effective at controlling acid the acid that has already been reflux. Most patients with Barrett's made. They may be either liquids Oesophagus will be taking one of or tablets and should be taken as these routinely.
working to prevent cancer of the gullet severe symptoms should consider Fundoplication surgery is a taking acid suppression tablets to treatment which aims to restore try and prevent complications of the normal valve at the lower end acid reflux such as scarring of the of the oesophagus which often does not work properly in people Surgery is usually reserved for with Barrett's Oesophagus. This people who do not respond well to treatment is often carried out as a lifestyle changes and drug therapy.
keyhole operation. You would onlyneed to stay in hospital for one or two days, although it usually takes four weeks to recover Treatments to prevent cancer completely from the operation.
Since the vast majority of patients Fundoplication surgery is with Barrett's Oesophagus do not successful in stopping acid reflux get cancer, the usual practice in in seven or eight of every ten the United Kingdom is not to people treated. It does have risks, attempt to remove the Barrett's so before agreeing to have surgery cells. Treatment is usually only it is important to discuss these offered if the cells look as though with the surgeon. Things which they are starting to change and the can trouble people after surgery risk of getting cancer starts to rise.
include bloating of the abdomen, Acid suppression and fundoplication difficulty in swallowing and, rarely, severe diarrhoea.
Although in theory, exposure to acid and bile may make cells more When to use which treatment likely to turn cancerous, there is Everyone with acid reflux should no clear evidence that aggressive try to make lifestyle changes. suppression of acid reflux does Often, simple changes to when actually reduce the risk of cancer.
and what they eat will make Decisions about these treatments people feel very much better.
should generally be made on the basis of symptoms.
Many people will still need to take drugs. People with frequent or cent per year with half of all This word is derived from the patients developing cancer in Greek meaning roughly "bad around five years. This means formation". It is used to describe that half of these people will NOT an abnormality within the tissue develop cancer in five years. This where the tissue changes and may needs to influence your decision in some cases progress to cancer.
about whether or not to have Dysplasia is the earliest form of pre-cancerous change that can be All people with high grade recognised and may be low grade dysplasia should be referred to a or high grade, the latter specialist centre where their case representing a more advanced is discussed by a multi-disciplinary progression towards cancer.
team of doctors and where the Treatment for people with low grade doctors perform minimally invasive but complex treatments frequently.
All these treatments aim to The risk of people with low grade remove the dysplasia. In addition, dysplasia getting cancer is only they may aim to replace the red, slightly higher than in people Barrett's Oesophagus, with normal without dysplasia. For this reason pink (squamous) lining.
most doctors do not recommend treatment for this condition.
Barrx radiofrequency ablation Most doctors would recommend This is now the recommended that you have check-ups with an treatment for Barrett's with high endoscopy every six months so that grade dysplasia, and has replaced they can monitor any changes in major surgery (oesophagectomy) the Barrett's cells. This is the as the treatment of choice for current guideline of the British dysplasia. However, in a small Society of Gastroenterology.
number of cases where early cancerous change has already Treatment for people with high grade occurred, resection may still be necessary. It uses electrical The risk of developing cancer is current produced by radio waves much higher for people with high to destroy the dysplasia and is grade dysplasia at about 10 per performed during an endoscopy.
working to prevent cancer of the gullet You will be given a sedative to This treatment is usually repeated make you sleepy. A probe will be three or four times at intervals of used to deliver the radio waves to two to three months until not only the affected parts. The procedure the dysplasia, but also the entire takes about 45 minutes.
Barrett's oesophagus has been removed. Treating circumferential and/or long Barrett's using Treating a small area of a balloon catheter.
disease using a focal Some people return to normal immediately after treatment, most After treatment patients have to have mild pain easily controlled continue regular surveillance as with simple pain killers for a few before, usually every 6 months days; however, some may have and then every year.
chest pain and nausea particularly Although radiofrequency ablation when they eat, for up to three is safer and has fewer side effects weeks after treatment. A very few than major surgery, the people (around 1 in 1100) suffer disadvantage is that it involves scarring of the oesophagus, but many endoscopies and the need this can normally be treated by for continued surveillance.
another endoscopy.
Images above Copyright Covidien GI Solutions used by permission. The use of any Barrx™ RF Ablation System photo or image does not imply Covidien review or endorsement of any article or publication Endoscopic Mucosal Resection Mucosal resection does not aim to Some patients with high grade remove the Barrett's cells dysplasia have a visible nodule in completely; it cannot remove their oesophagus. It is relatively large sections of affected straightforward to remove the oesophagus without causing nodule during endoscopy. The scarring and difficulty in procedure takes around 30-45 swallowing; however, usually minutes and you can usually go patients go on to have home the same day. If you have radiofrequency ablation to this procedure you will be given a complete treatment, as described sedative to make you slightly sleepy. Most people can eat and Research is going on all the time drink normally afterwards. In about into new ways to treat Barrett's one in ten people there may be oesophagus. New studies are minor bleeding, and more serious being published regularly. Please bleeding in one in 50 people.
speak to your specialist about the Endoscopic mucosal resection is current state of knowledge a particularly useful test if the regarding the treatments diagnosis is not clear because the removed nodule can be sent to the laboratory to be checked by the pathologist. In this situation, it serves as both a diagnostic test and a treatment. In a small number of cases, histology may show that early cancerous change has occurred, in which case, resection may be necessary.
working to prevent cancer of the gullet The facts:In the UK: 400,000 to 1 million people are estimated to have Barrett's Oesophagus.
At least 40,000 of these can be expected to develop oesophageal cancerup to 32,000 can be expected to die within five Founded as a charity in 1999, the Barrett's Oesophagus Campaign is the only national charity dedicated to the prevention of cancer from Barrett's Oesophagus and the support of people living with the condition.
provide a support and education service to people who suffer from Barrett's Oesophagus and their relatives and friendssupport research to better understand the condition raise awareness to encourage early detection If you would like to find out more about the Campaign's work, or the services they offer, please contact: The Barrett's Oesophagus Campaign UCL, Division of Durgery and Interventional ScienceRoyal Free and University College Medical School Rowland Hill StreetLondon NW3 2PF Tel: 020 7794 0500 Ext 23073 Registered Charity No. 1127495


Osteoporos IntDOI 10.1007/s00198-011-1528-y Skeletal mineralization defects in adulthypophosphatasia—a clinical and histological analysis F. Barvencik & F. Timo Beil & M. Gebauer & B. Busse &T. Koehne & S. Seitz & J. Zustin & P. Pogoda & T. Schinke &M. Amling Received: 14 April 2010 / Accepted: 3 January 2011 # International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Microsoft word - psyllid cop 5 oct 2012 edition 2.doc

New Zealand Code of Practice for the Management of the Tomato/Potato Psyllid in Greenhouse Tomato and Capsicum Crops Published by: Tomatoes New Zealand and Vegetables New Zealand 2nd Edition4 October 2012 Table of ContentsTable of Contents . 21. Relevant legislation and industry standards. 3 Information on the tomato/potato psyllid. 3