In Barrett’s esophagus, tissue in the tube connecting your mouth and stomach (esophagus) is replaced by tissue similar to the intestinal lining.
Barrett’s esophagus is often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. Only a small percentage of people with GERD will develop Barrett’s esophagus.
Barrett’s esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it’s important to have regular checkups for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent esophageal cancer.
The tissue changes that characterize Barrett’s esophagus cause no symptoms. The signs and symptoms that you experience are generally due to GERD and may include:
Many people with Barrett’s esophagus have no signs or symptoms.
The exact cause of Barrett’s esophagus isn’t known. Most people with Barrett’s esophagus have long-standing GERD.
In GERD, stomach contents wash back into the esophagus, damaging esophagus tissue. As the esophagus tries to heal itself, the cells can change to the type of cells found in Barrett’s esophagus.
However, some people diagnosed with Barrett’s esophagus have never experienced heartburn or acid reflux. It’s not clear what causes Barrett’s esophagus in these people.
Factors that increase your risk of Barrett’s esophagus include:
Treatment for Barrett’s esophagus depends on the extent of abnormal cell growth in your esophagus and your overall health.
Your doctor will likely recommend:
If low-grade dysplasia is found, it should be verified by an experienced pathologist. For low-grade dysplasia, your doctor may recommend another endoscopy in six months, with additional follow-up every six to 12 months.
But, given the risk of esophageal cancer, treatment may be recommended if the diagnosis is confirmed. Preferred treatments include:
If significant inflammation of the esophagus is present at initial endoscopy, another endoscopy is performed after you’ve received three to four months of treatment to reduce stomach acid.
High-grade dysplasia is generally thought to be a precursor to esophageal cancer. For this reason, your doctor may recommend endoscopic resection or radiofrequency ablation. Other options for treatment include:
Recurrence of Barrett’s esophagus is possible after treatment. Ask your doctor how often you need to come back for follow-up testing. If you have treatment other than surgery to remove abnormal esophageal tissue, your doctor is likely to recommend medication to reduce acid and help your esophagus heal.