Barrett’s Esophagus is a condition in which the tissue lining the esophagus is replaced by tissue that is similar to the lining of the intestine. This process is called intestinal metaplasia.

Barrett’s esophagus affects about one percent of adults in the United States. Men develop Barrett’s esophagus twice as often as women, and Caucasian men are affected more frequently than men of other races.

Symptoms

There are no symptoms associated with Barrett’s esophagus. However, Barrett’s esophagus is commonly found in people with gastroesophageal reflux disease, otherwise known as GERD, which is a more serious form of gastroesophageal reflux or acid reflux.

The muscular layers of the esophagus are normally pinched together at both the upper and lower ends, relaxing only to allow food or drink to pass from the mouth to the stomach when a person swallows. These muscles, also called sphincters, can spontaneously open for varying periods of time, allowing stomach contents and digestive acids to travel back up the esophagus. When this happens, stomach acid comes into contact with the lining of the esophagus, causing a burning sensation in the chest or throat.

Improvement in GERD symptoms may lower the risk of developing Barrett’s esophagus.

Complications

People with Barrett’s esophagus have a low risk of developing a kind of cancer called esophageal adenocarcinoma. Less than one percent of people with Barrett’s esophagus develop esophageal adenocarcinoma each year. Barrett’s esophagus may be present for several years before cancer develops. Esophageal adenocarcinoma is frequently not detected until its later stages when treatments are not always effective.

What causes Barrett’s esophagus?

The exact causes of Barrett’s esophagus are not known, but GERD is a risk factor for the condition. Although people who do not have GERD can have Barrett’s esophagus, the condition is found about three to five times more often in people who also have GERD.

Diagnosis

Because Barrett’s esophagus does not cause any symptoms, it is recommended that adults age forty and older who have had GERD for a number of years undergo an endoscopy with biopsies to check for the condition.

Barrett’s esophagus can only be diagnosed through biopsies taken during an endoscopic exam called an esophagogastroduodenoscopy (EGD). An EGDis a minimally invasive procedure that visualizes the upper part of the gastrointestinal tract from the mouth to the duodenum. If the tissue lining the esophagus appears suspicious, the doctor will remove several small pieces using a pincher-like device that is passed through the endoscope. These small pieces, known as biopsies, are then examined by a pathologist using a microscope to determine if they are consistent with Barrett’s esophagus.

Treatment

Once a diagnosis of Barrett’s esophagus has been made, periodic endoscopic examinations are highly recommended. These surveillance exams will allow the doctor to look for early warning signs of cancer. Typically, before esophageal cancer develops, precancerous cells appear in the Barrett’s tissue. This condition is called dysplasia and can only be seen through biopsies taken during an EGD. Detecting and treating dysplasia may prevent cancer from developing.

Endoscopic or surgical treatments can be used to treat Barrett’s esophagus with severe dysplasia or cancer. Your doctor will present the available options and help determine the best course of treatment.

Points to Remember

• In Barrett’s esophagus, the tissue lining the esophagus is replaced by tissue that is similar to the lining of the intestine.
• Barrett’s esophagus is associated with gastroesophageal reflux disease (GERD).
• Improvement in GERD symptoms with acid-reducing drugs may decrease the risk of developing Barrett’s esophagus.
• Barrett’s esophagus is diagnosed through an EGD and biopsies.
• People who have Barrett’s esophagus should have periodic surveillance endoscopies and biopsies.

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