Alcian blue stain

Since Barrett’s oesophagus has no particular signs and symptoms, your doctor may order this test if you have severe GERD or a history of GERD

The following are the symptoms of GERD:

• Chest pain
• Difficulty in swallowing
• Burning sensation in chest (heartburn) observed after eating, which might be worse at night 
• The feeling of a lump in your throat
• Regurgitation of food
• Acid reflux during the night with symptoms such as:
  • Sleep disturbance
  • Inflammation of larynx (voice box)
  • Persistent cough
  • New or worsening asthma

The test may be performed if you are experiencing some common symptoms of adenocarcinoma, which may be as follows:

• Abdominal pain
• Nausea or vomiting
• Fatigue
• Dark-coloured stools due to bleeding in the intestine (Read more: Gastrointestinal bleeding causes)
• Unintentional weight loss
• Anaemia
• Jaundice

You need to abstain from eating or drinking for up to eight hours before the test to ensure an empty stomach for the procedure. 

Let the doctor know if you are taking any drugs (prescribed or un-prescribed). This is because certain medicines may interfere with the test results and drugs like blood thinners may increase your risk of bleeding during the procedure. Your doctor may change the course of some of your medicines or may ask you to stop taking them for a while. 

Your doctor will use a procedure called an oesophageal endoscopic biopsy to study the tissue in your oesophagus and get a sample of abnormal tissue. Here is how it will be done:

• The doctor will administer a sedative and painkiller in the vein in your arm. He/she may also spray a local anaesthetic in your mouth and throat to numb the area. This helps prevent a gag reflex when the endoscope goes in. 
• He/she will ask you to lie on your left side, and will then insert an endoscope (a slender tube with a tiny camera at its tip) through your mouth into your oesophagus. 
• Once the endoscope enters the food piper it will help the doctor to visually examine the oesophageal epithelium. 
• If the doctor observes any abnormality, then he/she will conduct a biopsy of that site, which essentially includes taking a tiny tissue sample from the site. 

The entire procedure usually lasts for about 5-20 minutes.

Some risks associated with oesophageal biopsy are:

• Difficulty in breathing
• Spasms in the larynx 
• Low blood pressure
• Slow heartbeat
• Excessive sweating

Normal results:

Under normal conditions, a biopsy specimen of the oesophagus will have no staining on the alcian blue stain test.

However, an intestinal biopsy specimen will have intestinal-type of goblet cells that contain acidic mucus, and hence will show positive staining with the alcian blue stain.

Abnormal results:

If the biopsy specimen of the oesophagus is positively stained by the alcian blue stain, it indicates the presence of intestinal-type goblet cells and hence the presence of Barrett’s oesophagus. This test will also help your doctor to check if you have adenocarcinoma associated with Barrett’s oesophagus.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.