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
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.