Health Dictionary

Overview

Barrett’s esophagus must be differentiated from esophagitis, peptic ulcer disease, GERD, esophageal carcinoma and esophageal motor disorders.

Differentiating Barrett’s Esophagus from other Diseases

Barrett’s esophagus should be differentiated from the following diseases;

Esophagitis^[1]
- Pill esophagitis
- Eosinophilic esophagitis
- Infectious esophagitis

GERD^[2]^[3]
Esophageal carcinoma ^[4]
Peptic ulcer disease
Esophageal motor disorders

Disease	Signs and Symptoms								Barium esophagogram	Endoscopy	Other imaging and laboratory findings	Gold Standard
	Onset	Dysphagia			Weight loss	Heartburn	Other findings	Mental status
	Onset	Solids	Liquids	Type	Weight loss	Heartburn	Other findings	Mental status
Barrett’s esophagus	Gradual	+	–	Progressive	+/-	+	GERD Symptoms Chest pain Chronic cough Laryngitis Regurgitation Heartburn	Normal	Mid or high esophageal ulcer Mid or high esophageal web-like stricture Reticular mucosal pattern	The esophageal lining appears pink or red and velvety.	No any other test is done to diagnose Barrett’s esophagus	Esophageal Biopsy
Eosinophilic esophagitis	Gradual	+		Progressive	+/-	+/-	Chest pain Food impaction Cough	Normal	Multiple rings in the esophagus	Concentric rings of the esophagus– Trachealization of the esophagus	Increased serum IgE levels	Esophageal biopsy
Esophageal carcinoma	Gradual	+	+	Progressive	+	+/-	Lymphadenopathy Cachexia	Normal	Irregular stricture Pre-stricture dilatation Case courtesy of Dr Bruno Di Muzio, Radiopaedia.org, rID: 4232f	Esophageal obstruction Staging of disease	CT and PET scan is an optional test for staging of the disease	Biopsy
Motor disorders (Myasthenia gravis)	Gradual	+	+	Progressive	+/-	–	Ptosis Diplopia Fatigue	Normal	Stasis in pharynx and pooling in pharyngeal recesses	Velopharyngeal insufficiency Delayed swallowing function	CT may show anterior mediastinal mass (thymoma) Positive tensilon test	Anti–acetylcholine receptor antibody test
GERD	Gradual Sudden onset	+	–	Progressive	+/-	+	Cough Hoarseness	Normal	Free acid reflux Esophagitis with scarring Strictures Barrett’s oesophagus	Erythema, erosions and ulceration Barrett’s esophagus	Esophageal manometry may show decreased tone of LES	24 hour esophageal pH monitoring

References

↑ Moayyedi P, Talley NJ (2006). “Gastro-oesophageal reflux disease”. Lancet. 367 (9528): 2086–100. doi:10.1016/S0140-6736(06)68932-0. PMID 16798392. Unknown parameter |month= ignored (help)
↑ http://www.wrongdiagnosis.com/b/barretts_esophagus/misdiag.htm
↑ Badillo R, Francis D (2014). “Diagnosis and treatment of gastroesophageal reflux disease”. World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
↑ Saenko VF, Tutchenko NI, Kurilets IP, Deĭneka SV, Malinin VV (1985). “[Diagnosis and surgical treatment of nonepithelial stomach tumors]”. Klin Khir (5): 11–5. PMID 4021327.

[pmid16798392-1] Moayyedi P, Talley NJ (2006). “Gastro-oesophageal reflux disease”. Lancet. 367 (9528): 2086–100. doi:10.1016/S0140-6736(06)68932-0. PMID 16798392. Unknown parameter |month= ignored (help)

[2] ttp://www.wrongdiagnosis.com/b/barretts_esophagus/misdiag.htm

[pmid25133039-3] Badillo R, Francis D (2014). “Diagnosis and treatment of gastroesophageal reflux disease”. World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.

[pmid4021327-4] Saenko VF, Tutchenko NI, Kurilets IP, Deĭneka SV, Malinin VV (1985). “[Diagnosis and surgical treatment of nonepithelial stomach tumors]”. Klin Khir (5): 11–5. PMID 4021327.

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[2]

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Health Dictionary

Barrett's esophagus differential diagnosis

Introduction

Overview

Differentiating Barrett’s Esophagus from other Diseases

References