Barrett's Esophagus

Illustration of the anatomy of the digestive system, adult
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What is Barrett's esophagus?

Barrett's esophagus is a condition in which normal cells that line the esophagus, called squamous cells, turn into cells not usually found in humans, called specialized columnar cells. This process is called intestinal metaplasia because the specialized columnar cells are similar to the lining of the intestine. Damage to the lining of the esophagus causes the cells to change. 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.

What causes Barrett's esophagus?

Barrett's esophagus develops in some people who have chronic gastroesophageal reflux disease (GERD) or esophagitis (inflammation of the esophagus). It is believed that damage to the lining of the esophagus, caused by these conditions, causes these abnormal cell changes.

Illustration demonstrating gastroesophageal reflux
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People who have had long-standing heartburn are at risk for Barrett's esophagus and should discuss this with their physician.

What are the symptoms of Barrett's esophagus?

The following are the most common symptoms of Barrett's esophagus. However, each individual may experience symptoms differently. Symptoms may include:

  • waking in the night because of heartburn pain

  • vomiting

  • difficulty in swallowing

  • blood in vomit or stool

Some persons with this condition may be asymptomatic. The symptoms of Barrett's esophagus may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

Illustration of an esophagogastroduodenoscopy procedure
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How is Barrett's esophagus diagnosed?

In addition to physical examination, the physician will perform an endoscopy, during which a long, thin tube, called an endoscope, is inserted through the mouth and gently guided into the esophagus. This contains instruments that allow the physician to see the lining of the esophagus and remove a small tissue sample (a biopsy), which is examined in a laboratory to determine whether the normal squamous cells have been replaced with columnar cells. If a person complains of trouble swallowing, an upper GI barium study may be helpful in identifying areas of narrowing called strictures.

Treatment for Barrett's esophagus:

Specific treatment for Barrett's esophagus will be determined by your physician based on:

  • your age, overall health, and medical history

  • extent of the disease

  • your tolerance for specific medications, procedures, or therapies

  • expectations for the course of this disease

  • your opinion or preference

Currently, there is no cure for Barrett's esophagus. Once the cells in the esophageal lining have been replaced by columnar cells, they will not revert back to normal. Thus, treatment is aimed at preventing further damage from occurring by stopping acid reflux from the stomach. Treatment may include:

  • medication

    Medications such as H2 receptor antagonists and proton pump inhibitors, which reduce the amount of acid produced in the stomach, may be prescribed by your physician.

  • surgery

    Surgery to remove damaged tissue or a section of the esophagus may be necessary. Known as fundoplication, part of the esophagus is removed and the remaining section is attached to the stomach.

  • dilation procedure

    If strictures (narrowing of the esophagus) are present, caused when the damaged lining of the esophagus becomes thick and hardened, a procedure called dilation is used. During dilation, an instrument gently stretches the strictures and expands the opening of the esophagus.

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