Barrett's esophagus
Key points
- Barrett's esophagus is a disorder in which the lining of the esophagus (the tube which carries food from the throat to the stomach) is damaged by irritation from leaked stomach acid.
- Irritation of the lining of the esophagus by gastric acid secretions (stomach acid) causes Barrett's esophagus.
- Barrett's esophagus itself does not cause symptoms.
- Looking at the esophagus with an endoscope and obtaining a sample of esophagus tissue for examination (esophagoscopy with biopsy) may reveal Barrett's esophagus.
Definition
Barrett's esophagus is a disorder in which the lining of the esophagus (the tube which carries food from the throat to the stomach) is damaged by irritation from leaked stomach acid. This leakage of acid is commonly known as "heartburn" (gastroesophageal reflux).
Causes, incidence, and risk factors
Irritation of the lining of the esophagus by gastric acid secretions (stomach acid) causes Barrett's esophagus. It occurs more frequently in men than women. Risk factors are frequent and long-standing gastroesophageal reflux. The condition carries an increased risk of cancer of the esophagus.
Symptoms
Barrett's esophagus itself does not cause symptoms. The acid reflux that causes Barrett's esophagus results in symptoms of heartburn. Rarely, Barrett's esophagus can progress to cancer of the esophagus, which may cause difficulty swallowing or weight loss.
Signs and tests
Looking at the esophagus with an endoscope and obtaining a sample of esophagus tissue for examination (esophagoscopy with biopsy) may reveal Barrett's esophagus.
Treatment
Treatment includes general measures to control gastroesophageal reflux, medications, and surgery. Treatment may be important even if the patient doesn't feel any symptoms.
General measures include:
- Weight reduction
- Avoiding lying down after meals
- Sleeping with the head of the bed elevated
- Taking medication with plenty of water
- Avoiding dietary fat, chocolate, caffeine, and peppermint because they may cause lower esophageal pressure
- Avoiding alcohol and tobacco
Medications to relieve symptoms and control gastroesophageal reflux include antacids after meals and at bedtime, histamine H2 receptor blockers, proton pump inhibitors, cholinergic agents, and promotility agents.
Surgery to remove a portion of the esophagus (resection of the esophagus) may be indicated, if a biopsy shows the type of cellular changes that tend to lead to cancer (dysplasia).
Expectations (prognosis)
An increased risk of esophageal cancer is present. Follow-up endoscopy to look for dysplasia or cancer is often advised.
Complications
- Esophageal dysplasia
- Esophageal cancer
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.