Barrett’s esophagus

Overview – Barrett’s esophagus is characterized by changes in the tissue of the esophagus. The tissue in the esophagus is replaced by tissue similar to the intestinal lining. The esophagus is the tube connecting the mouth and the stomach.

This condition develops as a consequence of chronic gastroesophageal reflux disease (GERD). The chronic regurgitation of acid from the stomach into the lower esophagus causes the change in the tissue. However, some people diagnosed with Barrett’s esophagus have never experienced heartburn or acid reflux. It’s not clear what causes Barrett’s esophagus in these people.

The risk factors for Barrett’s esophagus are chronic heartburn or acid reflux, being white, being male, being overweight, history of smoking.

 

Symptoms

  • Barrett’s esophagus causes no symptoms. Most patient’s who have Barrett’s esophagus initially have symptoms of gastroesophageal reflux disease (GERD). These symptoms are frequent heartburn, difficulty swallowing food, chest pain.

 

Complications

  • Esophageal cancer – people with Barrett’s esophagus have an increased risk of esophageal cancer.

 

Symptoms to watch out for if you are diagnosed with Barrett’s esophagus –

  • Seek immediate help if you experience – difficulty swallowing, vomiting blood or blood that looks like coffee grounds, black tarry stools, or chest pain.

 

Screening for Barrett’s esophagus

  • According to the American College of Gastroenterology screening is recommended for men who have had symptoms of GERD at least weekly and who don’t respond to treatment with proton pump inhibitor medication, and who have at least two more risk factors, including being white, being over 50 years, being overweight with an abdominal pattern of fat distribution, being a current or past smoker, having a family history of Barrett’s esophagus or esophageal cancer.
  • Women are less likely to have Barrett’s esophagus, women are screened if they have uncontrolled symptoms of GERD or have the risk factors for Barrett’s esophagus.

 

Diagnosis

  • Endoscopy is done to determine if you have Barrett’s esophagus. A biopsy (removal of tissue) may be done to determine the degree of the change in the tissue.

 

Lifestyle management

  • Follow a healthy diet and exercise program as recommended by your doctor. Your doctor will recommend that you eliminate food foods that trigger heartburn such as chocolate, coffee, alcohol, and mint.
  • Stop smoking.
  • Elevate the head of the bed to prevent regurgitation.
  • Avoid late-night meals.
  • Overweight is a risk factor for Barrett’s esophagus. Maintain a healthy weight.
  • Keep all your appointments with your doctor. Recurrence of Barrett’s esophagus is possible after treatment.

 

Medical management

  • Acid reflux is treated with proton pump inhibitors.
  • Surgery may be an option to tighten the sphincter that controls the flow of stomach acid.
  • Low-grade dysplasia is treated with endoscopic resection, radiofrequency ablation to remove the damaged cells.
  • High-grade dysplasia is a precursor to esophageal cancer. Cryotherapy (cold liquid or gas is used to damage the abnormal cells), photodynamic therapy (light is used to destroy the abnormal cells), or surgery to remove the damaged part of the esophagus is done.

Pin It on Pinterest