Glossary

The definitions below are intended to provide you with a general understanding of the terms. Refer to a medical professional for more detailed information and to address any questions you may have.

Ablation: Removal or destruction of abnormal tissue.

Barrett's esophagus: A precancerous condition of the lining of the esophagus, commonly caused by chronic GERD.

Biopsy clearance rate (BCR): for a given patient at a given f/u interval - # negative bx / total bx

Buried Glands: Barrett's goblet cells that are hidden under a layer of squamous epithelium (cells that line the esophagus).

Colonoscopy: Procedure that allows inspection and tissue sampling of the rectum and large intestine by inserting a flexible tube with an attached camera through the rectum.

Columnar Epithelium: Cells that line the stomach and intestine. They have a pink/red appearance and are meant to tolerate the acidic nature of stomach contents as part of the digestive process.

Complete response (CR): For a given patient, 100% bx cleared of IM

Dysplasia: Abnormal tissue cells that are susceptible to developing into a malignant state.

Dysphagia: Difficulty in swallowing food or liquid.

Endoscopy: Diagnostic test wherein a thin, flexible tube is swallowed by the patient to allow the physician to directly inspect the lining of the upper gastrointestinal tract.

Esophagectomy: The surgical removal of the esophagus for the treatment of adenocarcinoma which involves removing the patient's esophagus and top part of the stomach. A portion of the stomach is then pulled up into the chest and connected to the remaining normal portion of the esophagus. The patient then has a "new" esophagus made up of the normal portion of the esophagus not removed at surgery connected to a portion of the stomach pulled up into the chest.

Esophageal Adenocarcinoma: Cancer that arises from the glands lining the esophagus and resembles cancers found in the stomach and intestinal tract.

Esophagus: Muscular tube that carries food, liquids and saliva from the mouth to the stomach. The esophagus transports food from the mouth to the stomach by coordinated contractions of its muscular lining.

Gastroenterologist: Physician who specializes in diagnosis and treatment of disorders of the gastrointestinal tract including the esophagus, stomach, small intestine, large intestine, pancreas, liver, gallbladder and biliary system.

Gastroesophageal Reflux Disease (GERD): Regurgitation of the stomach contents into the esophagus. Almost everyone experiences gastroesophageal reflux at some time. The most common symptom is heartburn, an uncomfortable burning sensation behind the breastbone, usually occurring after a meal. In some individuals this reflux is frequent or severe enough to cause more significant problems. GERD is a clinical condition that occurs when reflux of stomach acid into the esophagus is severe enough to impact the patient's life and/or damage the esophagus.

GERD Medications: H2 blockers such as ranitidine (Zantac®), cimetidine (Tagamet HB 200®), and famotidine (Pepcid®) are drugs that block one of the ways in which the stomach is stimulated to produce acid. Proton Pump Inhibitors (PPIs) such as omeprazole (Prilosec OTC®), esomeprazole (Nexium®), and lansoprazole (Prevacid) are medications that block histamines which in turn block acid production in the stomach.

High Grade Dysplasia: The most advanced stage of dysplasia with atypical changes in many of the cells and a very abnormal growth pattern of the glands. The growth pattern of the glands, or rows of cells, is distorted or very irregular. High-grade dysplasia is the diagnosis most widely used to identify a group of Barrett's patients who are at increased risk of developing adenocarcinoma of the esophagus. Not all patients who have high-grade dysplasia develop cancer.

Intestinal Metaplasia: Another term for Barrett's esophagus. Intestinal metaplasia, also known as IM, is the least serious stage of Barrett's esophagus.

Low Grade Dysplasia: Atypical changes in the cells that do not involve most of the cells and the growth pattern of the glands is still normal.

Malignancy: Cancerous cells that have the ability to spread, invade and destroy tissue. These cells tend to grow rapidly, invade and destroy nearby tissue, and may spread (metastasize) to other parts of the body. Those cells resistant to treatment may return after being removed or destroyed.

Median biopsy clearance rate: median BCR value for a group at a given f/u interval

Metaplasia: Phenomenon by which one type of tissue is replaced by another type.

Partial response (PR): For a given patient, 50-99% of bx cleared of IM

Squamous Epithelium: Cells that line the esophagus.

Stricture: Circumscribed narrowing of the esophagus.

TLESRs: transient lower esophageal sphincter relaxations. The primary factor known to cause esophageal reflux disease is inappropriate transient lower esophageal sphincter relaxations (TLESRs).

Upper GI Endoscopy: Visual diagnostic examination of the upper GI tract, esophagus, stomach and duodenum utilizing a flexible endoscope.

Citations

The above introduction to esophagus is provided compliments of BARRX.