Barrett's esophagus is a complication of chronic esophagitis, which is inflammation of the esophagus.
Barrett's esophagus is characterized by a change in the cells lining the esophagus. Normal cells are flat-shaped (squamous) cells, while Barrett's esophagus cells are shaped like a column. This cell change is called metaplasia . It is a premalignant phase that may eventually result in cancer of the esophagus if untreated.
The exact cause of Barrett's esophagus is unknown. However, it may result from damage to the esophagus caused by the chronic reflux of stomach acid. Frequent or chronic reflux of stomach acid into the esophagus is called gastroesophageal reflux disease , or GERD.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
Although Barrett's esophagus does not directly produce symptoms, people with GERD may experience the following:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
Once the cell changes of Barrett's esophagus occur, the changes are permanent. The goal of treatment is to prevent further damage by stopping the reflux of acid from the stomach. Treatment may include:
The following types of medications may be prescribed:
If the disease is severe or the medication is unsuccessful, your doctor may recommend surgery. Surgical options may include:
Your doctor may recommend endoscopy about (or at least) every 1-3 years to monitor the esophagus for early signs of cancer. This recommendation must be individualized for each person.
The best way to prevent Barrett's esophagus is to minimize and/or treat the reflux of stomach acid into the esophagus, which is usually due to GERD. In addition to drugs or surgery, self-care measures for GERD include:
RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov/
The Society of Thoracic Surgeons
http://www.sts.org/
CANADIAN RESOURCES:
Canadian Society of Intestinal Research
http://www.badgut.com/
Health Canada
http://www.hc-sc.gc.ca/index-eng.php
References:
Cameron AJ. Barrett's esophagus: prevalence and size of hiatal hernia. Am J Gastroenterol ; 1999;94(8):2054-2059.
Pereira-Lima JC, Busnello JV, Saul C. High power setting argon plasma coagulation for the eradication of Barrett's esophagus. Am J Gastroenterol ; 2000;95(7):1661-1668.
Rajan E, Burgart LJ, Gostout CJ. Endoscopic and histologic diagnosis of Barrett esophagus. Mayo Clin Proc . 2001;76(2):217-225.
Sampliner RE. Ablative therapies for the columnar-lined esophagus. Gastroenterol Clin North Am . 1997;26(3):685-694.
Sampliner RE, Fennerty B, Garewal HS. Reversal of Barrett's esophagus with acid suppression and multipolar electrocoagulation: preliminary results. Gastrointest Endosc . 1996;44(5):532-535.
The Society of Thoracic Surgeons website. Available at: http://www.sts.org . Accessed October 11, 2005.
Last reviewed September 2009 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.