Barrett Esophagus

Definition

The esophagus is a tube that carries food from the mouth to the stomach. Barrett esophagus is a condition that results in a change in the cells in the lower part of this tube.

Causes

The exact cause is not known. In some people, it may be caused by a backup of stomach acid into the tube. This is also known gastroesophageal reflux disease (GERD).

Gastroesophageal Reflux

Gastroesophageal Reflux
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Risk Factors

This problem is more common in men, people who are White, and people 50 years of age and older. Other things that may raise the risk are:

  • A history of heartburn or GERD
  • Obesity, especially around the midsection
  • Current or history of smoking
  • Having other family members with this problem
  • A history of hiatal hernia

Symptoms

Barrett esophagus does not cause symptoms. People with it often have symptoms of stomach acid reflux, such as:

  • A feeling of burning in the chest, especially after eating
  • Stomach content that flows back into the mouth
  • Sour taste in the mouth
  • Problems swallowing food

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor may want to test for Barrett esophagus if you have a history of heartburn or GERD.

The area will need to be viewed. This can be done with:

  • Upper GI endoscopy—a scope with a camera is passed down the throat to view the area
  • Biopsy—a sample of tissue is removed and examined in a lab to look for signs of cell changes

Treatment

The cells that have already been damaged cannot be changed. The goal of treatment is to stop the disease from damaging more cells. Choices are:

  • Monitoring the problem to look for changes
  • Medicine to prevent stomach acid from damaging the esophagus, such as proton pump inhibitors (PPIs)
  • Surgery to remove:
    • Unhealthy cells using laser light or radiowaves
    • Part of the esophagus

Prevention

To lower the risk of this health problem:

  • Manage symptoms of heartburn and GERD
  • Avoid smoking and drinking
  • Maintain a healthy weight

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
The Society of Thoracic Surgeons
https://www.sts.org

CANADIAN RESOURCES:

GI Society—Canadian Society of Intestinal Research
https://www.badgut.com

References:

Barrett esophagus. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/barrett-esophagus. Accessed November 24, 2020.
Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/barretts-esophagus. Accessed November 24, 2020.
Shaheen NJ, Falk GW, et al. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol. 2016 Jan;111(1):30-50.
11/30/2015 DynaMed's Systematic Literature Surveillance https://www.dynamed.com/condition/barrett-esophagus: Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG clinical guideline: diagnosis and management of Barrett's esophagus. Am J Gastroenterol. 2016;111(1):30-50.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 11/23/2020

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