Barrett Esophagus
Condition
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. This change puts a person at higher risk for getting cancer in that part of the esophagus.
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).
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Risk Factors
This problem is more common in men, people who are White, and people at least 50 years of age. Other things that may raise the risk are:
- A history of heartburn or GERD
- Obesity, especially around the midsection
- History of smoking or smoking currently
- 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 symptoms and health history. A physical exam will be done. The doctor may want to test for Barrett esophagus if there is 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 hurting more cells. Choices are:
- Watching the problem to look for changes
- Medicine to keep stomach acid from hurting the esophagus, such as proton pump inhibitors (PPIs)
- Surgery to remove:
- Unhealthy cells using laser light or radio waves
- Part of the esophagus
Prevention
To lower the risk of this health problem:
- Manage symptoms of heartburn and GERD
- Avoid food and drinks that can make GERD worse, such as tea, coffee, alcohol, fatty foods, peppermint, and chocolate
- Avoid smoking
- Keep a healthy weight
National Institute of Diabetes and Digestive and Kidney Diseases
The Society of Thoracic Surgeons
CANADIAN RESOURCES:
GI Society—Canadian Society of Intestinal Research
Health Canada
National Institute of Diabetes and Digestive and Kidney Diseases
The Society of Thoracic Surgeons
CANADIAN RESOURCES:
GI Society—Canadian Society of Intestinal Research
Health Canada
References
- Barrett esophagus. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/barrett-esophagus.
- 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.
- Shaheen, N.J., Falk, G.W., et al. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol, 2016; 111 (1): 30-50.
Contributors
- Marcin Chwistek, MD
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