BARRETT'S ESOPHAGUS: WHEN GERD WORSENS
We've all complained about
disease are most likely to develop the
heartburn, and some of us may
condition.
be taking medication for gas-
troesophageal reflux disease
"Only after a biopsy do we know it's
(GERD), commonly known as
Barrett's," says Dr. Baluch.
acid reflux. But when GERD
MEHDI
BALUCH, MD
becomes chronic, it can lead
INCIDENCE About I 3 percent of people
to a condition called Barrett's
with chronic acid reflux will have Barrett's
esophagus.
esophagus. It mostly affects Caucasian men
over age 50. More than 3 million people in
BACKGROUND Barrett's esophagus is a precancer-
the U.S. are affected by Barrett's.
ous condition that develops when too much acid from
the stomach back- flows and damages the lining of the
DIAGNOSIS AND TREATMENT To de-
esophagus—the tube that carries food and liquids from
termine if you have Barrett's esophagus,
the mouth to the stomach. The damage can cause the
your physician will order an endoscopy-
esophageal cells to be altered microscopically and in ap-
examination of your esophagus—and a
pearance, creating intestinal tissue, or Barrett's esophagus.
biopsy. The most common treatment for
Patients who have the condition could be at risk for
Barrett's esophagus is radiofrequency abla-
esophageal cancer.
tion (RFA). During this minimally invasive,
The physician inserts a catheter into the esophagus that emits heat
energy to remove the abnormal tissue.
outpatient procedure, the physician inserts a catheter
Patients may experience mild pain and nausea after the
CAUSE Mehdi Baluch, MD, a St. Joseph Mercy Oakland
into the esophagus that emits heat energy to remove
procedure, but these can be controlled with medication.
(SJMO) gastroenterologist, says Barrett's is caused by the
the abnormal tissue.The amount of energy used is regu-
Clear liquids for 24 hours and a soft-food diet for several
constant exposure of the esophageal lining to the acidic
lated so that only the damaged tissue is destroyed.The
days thereafter are recommended.
contents of the stomach. Diet may be a contributing factor.
procedure is performed without incisions and typically
takes less than 30 minutes.
PREVENTION To prevent Barrett's esophagus, see your
cause reflux and lead to the disease," he explains.
A narrowing or blockage of the esophagus and "minimal
toms of GERD, advises Dr. Baluch.
SYMPTOMS Dr. Baluch says that there are no symptoms
are risks, says Dr. Baluch."No hospital stay is required un-
For a referral to a St. Joe gastroenterologist, call the referral
for Barrett's esophagus, but people with chronic reflux
less there is a complication."
line at 800-372-6094,
physician if you're experiencing heartburn and other symp-
"Any diet that creates more acidity in the stomach can
blood loss, which can be controlled during the procedure,"
.e.rare.
HELP YOUR ADOLESCENT DEVELOP HEALTHY BEHAVIORS
Your child has reached the nether-
rules and consequences will increase the probability of a
world of adolescence. No longer
behavior change because they're a part of it."
a child and not yet an adult, your
DONALD
DEERING, PHD
child is testing the waters as well
PROBLEM-SOLVING Teaching the child problem-solving
as you and your patience. But
can help change a child's behavior, according to Dr. Deer-
you can have a peaceful, happy
ing. The process can help the child think through what
home if you understand your
he's about to do. Problem-solving skills require three
adolescent's behavior.
components:
.
• Hindsight. What happened in the past when I exhibited
this behavior? "
BACKGROUND Donald Deer-
• Insight. What can I do now?
• Foresight. If I do this now, what's the likely outcome?
ing, PhD, a St. Joseph Mercy Oakland (SJMO) counselor,
psychologist and behavior modification specialist, says that
in order to understand your child's behavior, you first have
To be successful, the "child has to go through that process
to understand the child.
in his head," Dr. Deering says.
"The child sees the world a certain way," says Dr. Deer-
ing. "The greater the parents' understanding of what the
When children help create house rules, they feel more
positive about following them.
child sees, the higher the probability we have in changing
their behavior"
BE POSITIVE Aim for the positive, and compliment the
child when he does well. "An unsolicited compliment
• Predictability. "We're going to do it like this every day."
has more value to a child than if they have to ask for it,"
• Consistency. "We won't waver from these expectations:'
advises Dr Deering.
Parents also need to understand their child's motivation.
"Kids are motivated by trying to get their needs met," he
"Without these elements in place, parents won't be
In summary, to help ensure healthy behaviors from your
adds.
successful in modifying their child's behavior," advises
adolescent, Dr. Deering encourages:
Dr. Deering.
• Talking to your children
• Touching your children appropriately, with hugs, high
adolescents can be mouthy, act out and worse. That's
At the same time, parents need to institute rules and
fives and kisses
when parents need to create rules to restore order and
prominently display them. Dr. Deering suggests having
• Teaching your children
ESTABLISHING RULES In trying to get what they want,
retain control. Four elements are vital to achieving this,
a family meeting at which the child can contribute rules
says Dr. Deering:
and consequences.The rules should be accompanied by a
These steps will help your child be the best person he or
• Boundaries. Let the child know what's expected of
checklist that the child can check off himself when he obeys.
she can be, and you the best parent.
him or her
• Structure. Create a timeline that says "This is what we
do every day"
"This creates a sense of pride and accomplishment," says
For a referral to a St. Joe behavioral medicine specialist,
Dr. Deering. "Getting the child invested in creating the
call 800-372-6094.
SUMMER 2071
7
MICHIGAN MEDICAL REPORT