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Barrett esophagus

Definition

Barrett esophagus is a disorder in which the lining of the esophagus is damaged by stomach acid. The lining becomes similar to that of the stomach.

Alternative Names

Barrett's esophagus; GERD - Barrett; Reflux - Barrett

Causes

When you eat, food passes from your throat to your stomach through the esophagus. The esophagus is also called the food pipe or swallowing tube. A ring of muscle fibers in the lower esophagus keeps stomach contents from moving backward.

If these muscles do not close tightly, harsh stomach acid can leak into the esophagus. This is called reflux or gastroesophageal reflux. It may cause tissue damage over time.

Barrett esophagus occurs more often in men than women. People who have had gastroesophageal reflux disease (GERD) for a long time are more likely to have this condition.

Symptoms

Barrett esophagus itself does not cause symptoms. The acid reflux that causes Barrett esophagus often leads to symptoms of heartburn. Many people with this condition do not have any symptoms.

Exams and Tests

You may need an endoscopy if GERD symptoms are severe or come back after treatment.

A thin tube with a camera on the end is inserted through your mouth. It is then passed into your esophagus and stomach.

While looking at the esophagus with the endoscope, tissue samples may be taken in different parts of the esophagus. These biopsies help diagnose the condition. They also help look for changes that could lead to cancer.

People with Barrett esophagus have an increased risk for esophageal cancer. However, cancer is not common. Your health care provider may recommend a follow-up endoscopy to look for cell changes that indicate cancer.

Treatment

TREATMENT OF GERD

Treatment should improve acid reflux symptoms, and may keep Barrett esophagus from getting worse. Treatment may involve lifestyle changes and medicines such as:

  • Antacids after meals and at bedtime
  • Histamine H2 receptor blockers
  • Proton pump inhibitors
  • Avoiding tobacco use

Lifestyle changes, medicines, and anti-reflux surgery may help with symptoms of GERD. However, these steps will not make Barrett esophagus go away.

TREATMENT OF BARRETT ESOPHAGUS

Surgery or other procedures may be recommended if a biopsy shows cell changes that may be cancer.

Some of the following procedures remove the harmful tissue in your esophagus:

  • Photodynamic therapy (PDT) uses a special laser device, called an esophageal balloon, along with a drug called Photofrin.
  • Other procedures use different types of high energy to destroy the precancerous tissue.
  • Surgery to remove the abnormal lining.

Outlook (Prognosis)

Treatment should improve acid reflux symptoms and may keep Barrett esophagus from getting worse. None of these treatments will reverse the changes that may lead to cancer.

When to Contact a Medical Professional

Call your provider if:

  • Heartburn lasts for longer than a few days, or you have pain or problems swallowing.
  • You have been diagnosed with Barrett esophagus and your symptoms get worse,
  • You develop new symptoms (such as weight loss, problems swallowing).

Prevention

Diagnosis and treatment of GERD may prevent Barrett esophagus.

References

American Gastroenterological Association, Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology. 2011;140(3):1084-91. PMID: 21376940 www.ncbi.nlm.nih.gov/pubmed/21376940.

Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):308-28. PMID: 23419381 www.ncbi.nlm.nih.gov/pubmed/23419381.

Spechler SJ, Souza RF. Barrett's esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 44.

Teran MD, Brock MV. The management of Barrett's esophagus. In: Cameron, JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4.

Review Date:1/22/2015
Reviewed By:Subodh K. Lal, MD, gastroenterologist at gastrointestinal specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Outcome Data

No data available for this condition/procedure.

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