Barrett’s Esophagus

barretts esophagus guideBarrett’s esophagus is a medical condition in which the lining of the esophagus begins to resemble the lining of the intestines. The tissue lining the esophagus is naturally sensitive, and is not intended to come in contact with digestive juices like acid from the stomach.
Repeated exposure to stomach acid causes irritation and inflammation of the esophageal lining. Over time, this constant irritation prompts esophageal cells to change into cells similar to those in the parts of the digestive system that are resistant to stomach acid.
Barrett’s esophagus occurs in people who suffer from chronic heartburn and acid reflux for an extended period of time, often 10 years or more. Barrett’s esophagus does not produce symptoms. Instead, you may still experience symptoms of reflux disease, which include:

  • Frequent heartburn
  • Indigestion
  • Chronic cough
  • Difficulty swallowing
  • Pain in the chest or upper abdomen

Barrett’s esophagus is an early form of dysplasia, which is the abnormal development of tissue. If cell mutation continues, esophageal cancer may develop.

Diagnosing Barrett’s Esophagus

Barrett’s esophagus is generally diagnosed following standard testing for gastroesophageal reflux disease (GERD). The cell mutation of the esophageal lining is typically visible during an endoscopic examination.
During an endoscopy, a long, thin tube is inserted through the mouth and directed along the esophagus. The tube is equipped with a camera, light and a series of surgical devices to evaluate the esophageal lining. If changes in the tissue of the esophagus are detected, a biopsy can be taken during the examination and reviewed by a pathologist.

Treatment Options

The first course of treatment for Barrett’s esophagus is to reduce the recurrence of acid reflux. This is accomplished through a series of lifestyle changes, medication and surgical treatment options.
If an endoscopic biopsy reveals that further cell changes in the esophagus greatly increases your risk for cancer, then surgery may be recommended to remove damaged tissue from the esophagus.
Surgical options include:

  • Endoscopic tissue removal: Areas with highly damaged cells are removed during an incisionless procedure.
  • Radiofrequency ablation: A catheter emitting high-frequency energy waves is inserted into the esophagus, destroying damaged esophageal tissue.
  • Photodynamic therapy (PDT): A pre-surgical injection makes damaged esophageal cells highly sensitive to light. Then, a special light is inserted into the esophagus using an endoscope. This destroys the damaged cells.
  • Cryotherapy: Another endoscopic procedure that uses cold liquid or gas to destroy mutated cells.

In severe circumstances an esophagectomy may be recommended, in which portions of the esophagus are removed.
If esophageal damage is found to be minor or your risk of cancer is determined to be low, then your reflux surgeon may choose to regularly monitor your esophagus through yearly endoscopy examinations. Reflux management through medication and lifestyle changes can limit further damage from the condition.