Barrett’s esophagus is a condition brought on by years of severe acid reflux or gastroesophageal reflux disease (GERD). Patients with this condition have damage to the swallowing tube that connects the throat and stomach together. Barrett’s esophagus manifests when the lining of the tube changes from one cell type to another, which puts a patient at a higher risk of contracting esophageal cancer. The best way to prevent or limit Barrett’s esophagus is to arrest the symptoms of acid reflux early on. There are treatments for Barrett’s, but they depend on the severity of the damage and how much abnormal cell growth there is.
A patient with Barrett’s esophagus will likely have had acid reflux for years. The more severe form of acid reflux, or heartburn, is GERD. Right between the esophagus and the lining of the stomach is an important valve, known as the lower esophageal sphincter (LES). This usualy stays closed to prevent stomach acid and other caustic contents from regurgitating into the esophagus. When you eat food or drink a beverage, the LES opens. In patients who have GERD, the LES does not function properly and does not stay closed, leaving stomach acid to find its way into the esophagus. If not treated, over time, the stomach acid damages the lining of the esophagus, and you may experience more severe symptoms. Symptoms of Barrett’s esophagus include:
Chest pain is the least common symptom of Barrett’s esophagus; however, if you experience chest pain, please seek urgent care or see your doctor immediately.
The most prominent risk factor for Barrett’s esophagus is long-standing GERD or acid reflux. However, there are other factors (typically in combination with GERD) that increase your chances of developing Barrett’s. These include:
If you’re experiencing severe GERD symptoms, especially if acid reflux is constant, you should contact your gastroenterologist so they can offer you diagnosis and treatment.
The most common way to test for Barrett’s esophagus is upper endoscopy. While under anesthesia, your gastroenterologist will insert a long, thin tube with a small camera, called an endoscope. The scope can see the first part of the digestive tract, from the mouth to the duodenum (beginning of the small intestine). Your doctor can take a tissue sample of your esophagus with the endoscope and have it tested for Barrett’s esophagus. If Barrett’s esophagus is detected, the results will indicate either no dysplasia, low-grade dysplasia (some precancerous cells), or high-grade dysplasia (stage right before the development of esophageal cancer). The treatment for Barrett’s esophagus depends on the degree of dysplasia.
The treatment your doctor recommends depends entirely on the degree of dysplasia present in your esophagus. The most common treatments by stage for Barrett’s include:
After you receive endoscopic resection, radiofrequency ablation, or cryotherapy, you will schedule a follow-up endoscopy three to four months after treatment to ensure there is no dysplasia. It is also possible for Barrett’s esophagus to return after treatment.
While the last stage of Barett’s esophagus is a precursor to cancer, the overall lifetime risk for one to get esophageal cancer from barett’s is about 5%. Regular testing is wise to ensure that dysplasia is not developing. Barrett’s esophagus can return after treatment, but your physician can treat it again and retest. Your gastroenterologist may also recommend not eating right before bedtime, skipping spicy and acidic foods, avoiding larger meals, quitting smoking, and limiting carbonated beverages and alcohol. These are all directives for lessening the symptoms of GERD.
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