Common complications are:
1. The incidence of ulcer caused by Barrett's esophagus is 2% ~ 54%. After the columnar epithelium of esophagus is corroded by acidic digestive juice, it can produce ulcer, and the pain can radiate to the back, and it can also cause perforation, bleeding and infiltration. After the ulcer heals, it is narrow and has symptoms of dysphagia. It can even penetrate the aorta, causing massive bleeding and rapid death. Barrett ulcer has two pathological types, the most common is superficial ulcer of squamous epithelial segment, similar to ulcer caused by reflux esophagitis. Another rare type is deep ulcer of columnar epithelial segment, which is similar to peptic ulcer.
2. Esophageal stenosis is the most common complication of Barrett's esophagus, and the incidence rate is 15% ~ 100%. Stenosis is mostly located at the junction of squamous epithelium and columnar epithelium in the middle and upper esophagus, while stenosis caused by gastroesophageal reflux is mostly located in the lower esophagus. The incidence of reflux esophagitis is 29% ~ 82%. Lesions can only involve columnar epithelium, or both squamous epithelium and columnar epithelium.
3. The incidence of cancer in Barrett's esophagus is uncertain, and long-term reflux may play a malignant role in Barrett's esophagus. However, some studies believe that anti-reflux surgery for Barrett's esophageal disease patients can not make these columnar epithelium disappear, nor can it reduce the risk of malignant transformation. Barrett's esophageal columnar epithelium can produce dysplasia, and the degree can be from low to high. Low-grade dysplasia is sometimes indistinguishable from normal columnar epithelium, and high-grade dysplasia is sometimes indistinguishable from carcinoma in situ, which can progress to invasive carcinoma. These malignant tumors are adenocarcinoma. It should be pointed out that the endoscopic manifestations of cardiac adenocarcinoma with benign columnar epithelium are different from those of atypical hyperplasia of columnar epithelium as adenocarcinoma. Barrett's esophageal dysplasia is a precancerous lesion, which has been recognized by most people.
4. Gastrointestinal bleeding can be manifested as hematemesis or bloody stool, accompanied by iron deficiency anemia, the incidence rate is about 45%, and its bleeding sources are esophagitis and esophageal ulcer.