Heartburn/GERD Health Center

Barrett's Esophagus: Symptoms, Causes, and Treatments

Barrett's esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett's esophagus, normal tissue lining the esophagus -- the tube that carries food from the mouth to the stomach -- changes to tissue that resembles the lining of the intestine. About 10%-15% of people with chronic symptoms of GERD develop Barrett's esophagus.

Barrett's esophagus does not have any specific symptoms. Patients with Barrett's esophagus may have symptoms related to GERD. It does, though, increase the risk of developing esophageal adenocarcinoma, which is a serious, potentially fatal cancer of the esophagus.

Although the risk of this cancer is higher in people with Barrett's esophagus, the disease is still rare. Less than 1% of the people with Barrett's esophagus develop this particular cancer. Nevertheless, if you've been diagnosed with Barrett's esophagus, it's important to have routine examinations of your esophagus. With routine examination, your doctor can discover precancerous and cancer cells early, before they spread and when the disease is easier to treat.

What Is GERD and How Does It Relate to Barrett's Esophagus?

People with GERD experience symptoms such as heartburn, a sour, burning sensation in the back of the throat, and other symptoms such as chronic cough, laryngitis, and nausea.

When you swallow food or liquid, it automatically passes through the esophagus, which is a hollow, muscular tube that runs from your throat to your stomach. The lower esophageal sphincter, a ring of muscle at the end of the esophagus where it joins the stomach, keeps stomach contents from rising up into the esophagus.

The stomach produces acid in order to digest food, but it is also protected from the acid it produces. With GERD, stomach contents flow backward into the esophagus. This is known as reflux.

Most people with acid reflux don't develop Barrett's esophagus. But in patients with frequent acid reflux, over time the normal cells in the esophagus may be replaced by cells that are similar to cells in the intestine to become Barrett's esophagus.

Does GERD Always Cause Barrett's Esophagus?

No. Not everyone with GERD develops Barrett's esophagus. And not everyone with Barrett's esophagus had GERD. But long-term GERD is the primary risk factor.

Anyone can develop Barrett's esophagus, but white males who have had long-term GERD are more likely than others to develop it. Other risk factors include the onset of GERD at a younger age and a history of current or past smoking.

How Is Barrett's Esophagus Diagnosed?

Because there are often no specific symptoms associated with Barrett's esophagus, it can only be diagnosed with an upper endoscopy and biopsy. In general, doctors recommend that people over the age of 40 who have a long-term history of GERD be screened for Barrett's esophagus.

To perform an endoscopy, a doctor called a gastroenterologist inserts a long flexible tube with a camera attached down the throat into the esophagus after giving the patient a sedative. The process may feel a little uncomfortable, but it isn't painful. Most people have little or no problem with it.