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Barrett's Esophagus

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Updated April 30, 2012

Barrett's esophagus is a disorder in which the lining of the esophagus is damaged. This damage occurs when parts of the esophageal lining are repeatedly exposed to stomach acid, and are replaced by tissue that is similar to what is found intestine. This process is called intestinal metaplasia.

The cells in the lining of the esophagus and the stomach have different functions, and are different types of cells. Also, their appearance is very different, making it easy for a physician to tell them apart when examining the esophagus and stomach. At the end of the esophagus, there is an area that marks the border between the cells of the esophagus and the cells of the stomach. With Barrett's esophagus, abnormal intestinal-like cells develop above this border.

Causes of Barrett's Esophagus

Barrett's esophagus is uncommon. The most common risk factor for Barrett's esophagus is long-term gastroesophageal reflux disease (GERD), though only a small percentage of GERD patients will develop Barrett's esophagus. However, once Barrett's esophagus is present, there is a greater risk of developing esophageal cancer. Statistics show, though, that while the risk is increased, the overall risk is less than 1% per year of Barrett's esophagus patients developing this cancer.

When stomach acid backs up into the esophagus, it can cause injury to the normal lining of the esophagus. Esophageal injury with inflammation is called esophagitis. If this injury to the esophagus continues over many years, the injured normal lining of the esophagus will not grow back. Instead, it is replaced by an abnormal lining called Barrett's esophagus.

Symptoms of Barrett's Esophagus

Barrett's esophagus itself does not produce any symptoms. The acid reflux that causes Barrett's esophagus can have the symptoms of heartburn. If Barrett's esophagus has progressed to cancer of the esophagus, the symptoms can include difficulty swallowing or weight loss. Barrett's esophagus itself, however, does not cause symptoms.

Diagnosing Barrett's Esophagus

Individuals who have experienced acid reflux symptoms for a number of years should undergo an upper endoscopy exam to determine if they have Barrett's esophagus. Tissue samples from abnormal looking areas of the esophagus are taken during this procedure and examined under a microscope for the presence of abnormal cells. Tissue, showing intestinal metaplasia with goblet cells, is necessary to make the diagnosis of Barrett’s esophagus.

Treating Barrett's Esophagus

The best treatment strategy for Barrett's esophagus is prevention. When people are diagnosed with GERD, their doctor will work with them on lifestyle and diet modifications, and possible medications (such as antacids, proton pump inhibitors, and H2 blockers) to control the acid reflux.

Currently, there are no medications that will reverse Barrett's esophagus. Treating the underlying GERD, however, may slow the progress of the disease and help prevent complications. This includes:

  • Eating smaller, more frequent meals
  • Limiting intake of acid-stimulating foods and beverages
  • Not laying down for about two hours after you eat
  • Elevating the head a few inches while you sleep
  • Maintaining a reasonable weight
  • Quit smoking
  • Avoiding drink alcohol
  • Not wearing belts or clothes that are tight fitting around the waist
  • Taking any doctor-prescribed medications for acid reflux symptoms

Prognosis

An increased risk of esophageal cancer is present. A follow-up endoscopy to look for dysplasia or cancer is important.

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Related Resources:

Another Complication - Esophageal Cancer

Another Complication - Erosive Esophagitis

More About GERD

Sources:

Ijeoma A. Azodo, Yvonne Romero, M.D.. "BARRETT'S ESOPHAGUS." American College of Gastroenterology. 17 Nov 2007.

"Barrett's Esophagus." NIH Publication No. 05–4546 December 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 17 Nov 2007.

"Photodynamic Therapy for Cancer: Questions and Answers." National Cancer Institute. 17 Nov 2007.

  1. About.com
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  3. Heartburn / GERD
  4. Complications of Heartburn
  5. Barrett's Esophagus
  6. What is Barrett's Esophagus

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