Barrett's esophagus is a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid and changed to a lining similar to that of the stomach.
When you eat, food passes from your throat to your stomach through the esophagus (also called the food pipe or swallowing tube). Once food is in the stomach, a ring of muscles keeps it from leaking backward into the esophagus.
If these muscles do not close tightly, stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux.
Reflux may cause symptoms of heartburn. It may also damage the lining of the esophagus. The esophagus lining then changes in appearance and looks like the stomach lining (Barrett's esophagus).
Barrett's esophagus occurs more often in men than women. You are more likely to have this condition if you have had GERD for a long time.
Patients with Barrett's esophagus may develop more changes in the esophagus called dysplasia. When dysplasia is present, the risk of getting cancer of the esophagus increases.
Barrett's esophagus itself does not cause symptoms. The acid reflux that causes Barrett's esophagus often leads to symptoms of heartburn. However, many patients with this condition do not have symptoms.
Signs and tests
If GERD symptoms are severe or they come back after you have been treated, the doctor may perform an endoscopy.
A thin tube with a camera on the end is inserted through your mouth, then passed into your esophagus and stomach.
While looking at the esophagus with the endoscope, the doctor may perform biopsies in different parts of the esophagus. These biopsies help diagnose Barrett's esophagus, and look for changes that could lead to cancer.
People with Barrett's esophagus have an increased risk for esophageal cancer. Still, only a small number of people with Barrett's esophagus develop cancer. Your health care provider may recommend a follow-up endoscopy to look for changes that may lead to cancer (dysplasia), or for cancer itself.
TREATMENT OF GERD
Treatment should improve acid reflux symptoms, and may keep Barrett's esophagus from getting worse. Treatment may involve lifestyle changes and medications such as:
Wang, KK and Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Am J Gastroenterol. 2008;103:788-797.
Shaheen NJ, Sharma P, Overholt BF, Wolfsen HC, Sampliner RE, Wang KK, et al. Radiofrequency ablation in Barrett's esophagus with dysplasia. N Engl J Med. 2009;360:2277-2288.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.