Barrett’s Esophagus

Barrett's esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett's esophagus, normal tissue lining the esophagus -- the tube that carries food from the mouth to the stomach -- changes to tissue that resembles the lining of the intestine. About 10%-15% of people with chronic symptoms of GERD develop Barrett's esophagus.

Quick Facts

Symptoms:

Barrett's esophagus does not have any specific symptoms. Patients with Barrett's esophagus may have symptoms related to GERD. It does increase the risk of developing esophageal adenocarcinoma, which is a serious, potentially fatal cancer of the esophagus.

Although the risk of this cancer is higher in people with Barrett's esophagus, the disease is still rare. Less than 1% of the people with Barrett's esophagus develop this particular cancer. Nevertheless, if you've been diagnosed with Barrett's esophagus, it's important to have routine examinations of your esophagus. With routine examination, your doctor can discover precancerous and cancer cells early, before they spread and when the disease is easier to treat.

Diagnosis:

Because there are often no specific symptoms associated with Barrett's esophagus, it can only be diagnosed with an upper endoscopy and biopsy. In general, doctors recommend that people over the age of 40 who have a long-term history of GERD be screened for Barrett's esophagus.

Common Treatments:

One of the primary goals of treatment is to prevent or slow the development of Barrett's esophagus by treating and controlling acid reflux. This is done with lifestyle changes and medication. Lifestyle changes include taking steps such as:

  • Make changes in your diet. Fatty foods, chocolate, caffeine, spicy foods, and peppermint can aggravate reflux.
  • Avoid alcohol, caffeinated drinks, and tobacco.
  • Lose weight. Being overweight increases your risk for reflux.
  • Sleep with the head of the bed elevated. Sleeping with your head raised may help prevent the acid in your stomach from flowing up into the esophagus.
  • Don't lie down for 3 hours after eating.
  • Take all medicines with plenty of water.
The doctor may also prescribe medications to help. Those medications may include:
  • Antacids to neutralize stomach acid.
  • H2 blockers that lessen the release of stomach acid.
  • Promotility agents -- drugs that speed up the movement of food from the stomach to the intestines.
  • Proton pump inhibitors that reduce the production of stomach acid.
There are several treatments, including surgery, that are designed specifically to focus on the abnormal tissue:
  • Photodynamic therapy (PDT) uses a laser that's inserted into the esophagus with the endoscope to kill abnormal cells in the lining without damaging normal tissue.
  • Endoscopic mucosal resection (EMR) lifts the abnormal lining and cuts it off the wall of the esophagus before it's removed through the endoscope.
  • Surgery to remove most of the esophagus is an option in cases where severe precancer (dysplasia) or cancer has been diagnosed. The earlier the surgery is done following the diagnosis, the better the chance for the cure.

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