The esophagus is a tube that carries food from your mouth to your stomach. Barrett esophagus is a change to the cells of this tube.
This change means there is a higher risk of cancer developing. Treatment can lower the risk or catch cancer early.
The exact cause of Barrett esophagus is not known. Regular, long term damage and inflammation to the area may play a role. A back up of stomach acid into the tube is the most common cause of damage. This is also known as heartburn or
gastroesophageal reflux disease
The doctor will ask about your symptoms and past health. A physical exam will be done. The doctor may want to test for Barrett esophagus if you have a history of GERD.
The area will need to be closely examined. Tests may include:
Upper GI endoscopy—a scope is passed down the throat. A camera will allow the doctor to see any abnormal areas
Biopsy—a sample of abnormal tissue is removed. It will be examined in a lab. This will show changes to the cells.
There is a range of cell changes. High grade changes are at greater risk of cancer.
The cell changes that have already occurred can not be changed. The goals of treatment are to stop more damage to the area. The medical team will also remove high risk cells and check often for risk of cancer. Treatment options for Barrett esophagus may include:
Medicine may help to control reflux. The most common choice is proton pump inhibitors (PPIs). PPIs help control symptoms and
slow or stop further damage.
Surgery may be needed to treat severe GERD or remove unhealthy cells. Options include:
This surgery can help to control severe GERD. A part of the stomach is wrapped around the esophagus. It will help to keep stomach acid in the stomach.
A scope is passed down the throat. A camera will show the lining of the throat and abnormal cells. Tools can be passed down the scope to destroy abnormal cells. Normal cells can then grow over the area. There are different ways to kill the cells. Examples include:
Photodynamic therapy—uses laser light
Radiofrequency ablation—uses radiowaves
Part of the esophagus is removed. This may be needed for areas that have a very high risk of becoming cancer soon. The stomach may be pulled up or the area is replaced with a section of large intestine.
Follow up tests will be done to check for any new changes. They may be needed every 3 months to 5 years. The rate of follow up will depend on the type of cells that are present.
The best way to prevent Barrett esophagus is to stop irritation of the tissue. Steps may include:
Not smoking. If you smoke,
talk to your doctor about steps to help you
Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/barretts-esophagus. Accessed April 4, 2018.
Last reviewed March 2018 by
EBSCO Medical Review Board
Daus Mahnke, MD
Last Updated: 1/4/2019
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