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What Is Barrett's Esophagus?

Barrett's esophagus is when the normal cells that line the food pipe (esophagus) turn into cells not usually found in the esophagus, but rather they are typically found in the small intestine. This may occur after the lining of the esophagus has been damaged by injury and inflammation.

While it is still rare that someone with this disease will get cancer of the esophagus, having Barrett's esophagus may raise your risk of having esophageal cancer.

 


What Causes Barrett's Esophagus?

You may get Barrett's esophagus if you have frequent heartburn (gastroesophageal reflux disease or GERD, also called acid reflux disease) that lasts for many years. You may also get it if you have inflammation of the esophagus (esophagitis). The long-term inflammation and injury in the esophagus may lead to Barrett’s esophagus.

If you have long-term (chronic) heartburn, you are at risk for Barrett's esophagus. You should talk with your healthcare provider.

 


Who Is At Risk For Esophageal Cancer?

You are at increased risk for esophageal cancer if you are or have:

  • Chronic and/or frequent reflux
  • Over 50 years old
  • Male
  • White
  • Obese (particularly around the central portion of the body)
  • Smoker
  • Family history of esophageal cancer

Barrett’s esophagus is a known risk factor for esophageal cancer. There is a progression from Barrett’s esophagus to dysplasia (which is precancerous change) and then cancer. Among those patients who are diagnosed with Barrett’s esophagus, 

The presence of high-grade dysplasia is the best marker that we have to identify who may go on to develop esophageal cancer.

 


What Are the Symptoms of Barrett's Esophagus?

Barrett’s esophagus in and of itself does not cause symptoms. Often when people do have symptoms, they are symptoms of GERD or from a complication of GERD or Barrett’s esophagus.

 


How Is Barrett's Esophagus Diagnosed?

Your healthcare provider may recommend a screening endoscopy to check to see if you have Barrett’s esophagus if you have multiple risk factors for esophageal cancer. The procedure involves a long, thin tube with a camera (endoscope) that is put in your mouth and gently pushed down into your esophagus, typically under sedation. Your doctor uses the camera to see the lining of your esophagus. He or she will use the tools to remove a small tissue sample (a biopsy). This tissue sample will be sent to a lab. It will be checked to see if the tissue has any inflammation or Barrett’s lining. When people have Barrett’s esophagus, it is also important to confirm there is no evidence of cancer and check for “dysplasia” which is the presence of precancerous cells.

 


How is Barrett’s Esophagus Managed?

Most people who have Barrett’s esophagus without any evidence of precancerous cells (dysplasia) are monitored in a surveillance program with endoscopic procedures to check for any development of dysplasia. A typical surveillance interval between endoscopy procedures to monitor Barrett’s esophagus is 3 – 5 years.

Some people with Barrett’s esophagus who are at higher risk of developing esophageal cancer benefit from the treatment of Barrett’s esophagus. Treatment may involve multiple sessions and may include more than one approach. Endoscopic treatment approaches include endoscopic mucosal resection (cutting the tissue), radiofrequency ablation (burning the tissue), and/or cryotherapy (freezing the tissue).

We provide a thorough consultation with patients with Barrett’s esophagus to help them understand their risk of cancer and the benefit and risk of the management options available to pursue the best plan to optimize benefit and minimize risk for each individual.