Barrett’s Esophagus

What is Barrett’s esophagus?

Barrett’s esophagus is a condition in which normal tissue lining of the esophagus (the eating tube that connects the mouth to the stomach) turns into tissue that is similar to the lining of the intestine. This process is called intestinal metaplasia.

What causes Barrett’s esophagus?

The exact causes of Barrett’s esophagus are not known. It is believed that damage to the lining of the esophagus causes the cells to change. Having chronic heartburn, GERD (GastroEsophageal Reflux Disease) or esophagitis (inflammation of the esophagus) can cause this damage and abnormal cell changes.

• Although people who do not have GERD can have Barrett’s esophagus, the condition is found more often in people who do have GERD and/or long-standing heartburn.

What are the symptoms of Barrett’s esophagus?

There really are no symptoms of Barrett’s itself but some people have a history of long standing heartburn, indigestion and acid reflux, occurring at least two times a week. Other symptoms could be difficulty swallowing, waking up at night because of heartburn pain, unexplained cough or hoarseness.

• Some people with Barrett’s may have no or very little heartburn and no warning but may have significant damage to their esophageal tissue lining.

What are the complications of Barrett’s esophagus?

Anytime a cell lining changes in the body, there is the potential for cancerous changes. Less than 1 percent of people with this condition develop cancer of the esophagus. However, having Barrett’s esophagus may increase the risk of developing esophageal cancer.

How is Barrett’s esophagus diagnosed?

Barrett’s esophagus can only be diagnosed by getting small tissue samples, (biopsies) of the esophagus during an upper endoscopy. A pathologist then examines the tissue with a microscope to determine the types of cells and degree of changes in the tissue. Dysplasia is a precancerous change (not cancer yet) and can be thought of as an early warning signal. Low grade dysplasia is seen most often and is less cause for concern but requires repeat scoping and biopsies. If high grade dysplasia is found, the risk of cancer is greater, and requires more frequent scoping and biopsies.

How is Barrett’s esophagus treated?

Treatment is to prevent any further damage from acid reflux in your esophagus and stomach. Your health care provider will suggest:

• Medicines to reduce the amount of acid produced in your stomach, such as proton pump inhibitors (PPIs) and H2 receptor antagonists.
• Keeping a closer watch on esophageal acid damage by having repeated upper endoscopies and biopsies obtained (every 6 months to every 2 years).
• For severe dysplasia, certain procedures are available to destroy the Barrett’s lining such as Radiofrequency Ablation therapy. Even if symptoms are under control, repeated upper endoscopy screening examinations are recommended to monitor the degree of dysplasia.
• Even if symptoms are under control, repeated screening scope examinations the degree of dysplasia.