Barrett’s Esophagus

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Barrett’s Esophagus

In Barrett’s esophagus, tissue in the tube connecting your mouth and stomach (esophagus) is replaced by tissue similar to the intestinal lining.
It is often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. Only a small percentage of people with GERD will develop Barrett’s esophagus.

Barrett’s esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it’s important to have regular checkups for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent esophageal cancer.

Symptoms

The tissue changes that characterize Barrett’s esophagus cause no symptoms. The signs and symptoms that you experience are generally due to GERD and may include:
Frequent heartburn
Difficulty swallowing food
Less commonly, chest pain
Many people with Barrett’s esophagus have no signs or symptoms.

Why does Barrett’s esophagus develop?

The exact cause of Barrett’s esophagus isn’t known. Most people with Barrett’s esophagus have long-standing GERD, where stomach contents wash back into the esophagus, damaging esophagus tissue. As the esophagus tries to heal itself, the cells can change to the type of cells found in Barrett’s esophagus.
There are certain genes that have been discovered that may explain why some people with Barrett’s have a higher risk of developing cancer.
Risk factors
Factors that increase your risk of Barrett’s esophagus include:

  • Chronic heartburn and acid reflux. Having GERD that doesn’t get better when taking medications known as proton pump inhibitors or having GERD that requires regular medication can increase the risk of Barrett’s esophagus.
  • Barrett’s esophagus can occur at any age but is more common in older adults.
  • Men are far more likely to develop Barrett’s esophagus.
  • Obesity. Body fat around your abdomen further increases your risk.
  • Current or past smoking.

Diagnosis

The diagnosis of Barrett’s is made on endoscopy, where a special light through the endoscope allows the different linings to be identified. The length and extent of the suscpeted Barrett’s esopahgus is then recorded and classified using a system called the Prague Classification. Biopsies are then taken to confirm the diagnosis and exclude cancer.

Treatment

Treatment involves treating the reflux causing the Barrett’s esophagus, and often involves the use of acid suppressants and lifestyle changes. This will be assessed and decided upon by your doctor.

Complications

People with Barrett’s esophagus have an increased risk of esophageal cancer. The risk is small, even in people who have precancerous changes in their esophagus cells. Most people with Barrett’s esophagus will never develop esophageal cancer.

Surveillance

Individuals with Barrett’s esophagus require surveillance to make sure the segment of Barrett’s is not becoming abnormal (dysplastic) or cancerous. This usually involves an upper GI endoscopy once every 3 years.

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