The esophagus is a tube that carries food from your mouth to your stomach. Chronic esophagitis is inflammation of the esophagus. Barrett's esophagus is a complication of chronic esophagitis.
Barrett's esophagus is a change in the cells that line the esophagus. Normal cells are flat-shaped squamous cells. Barrett's esophagus cells are shaped like a column. This cell change is called metaplasia. It is a premalignant phase that may result in esophageal cancer if it is not treated.
The exact cause of Barrett's esophagus is not known. 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 (GERD).
Barrett's esophagus is more common in Caucasian men and in people aged 50 years and older. Other factors that may increase your chance of Barrett's esophagus include:
- Chronic heartburn or a history of GERD
- Obesity, especially around the midsection
- Current or history of smoking
- Family history of Barrett's esophagus or esophageal cancer
In some cases Barrett's esophagus may not produce symptoms.
Some people with GERD may have the following symptoms:
- Sore throat or chronic cough
- Hoarse voice
- Sour taste in mouth from acid reflux
More serious symptoms include:
- Difficulty or pain with swallowing, a condition called dysphagia
- Weight loss
- Fatigue, or difficulty or pain with breathing associated with anemia
The cell changes from Barrett's esophagus are permanent once they occur. Talk to your doctor about the best treatment options for you. Treatment may include:
Your doctor may recommend the proton pump inhibitors (PPIs). PPIs help control GERD symptoms and prevent further damage to the esophagus.
Your doctor may recommend surgery if the disease is severe or the medication is not helpful. Surgical options may include:
A part of the upper stomach is wrapped around the esophagus. This is done to reduce further damage caused by GERD.
Endoscopic eradication destroys the Barrett's cells in the esophagus. Eventually, the body starts making normal esophageal cells where the Barrett's cells used to be. The most common endoscopic eradication procedures include:
- Photodynamic therapy—uses laser light
- Radiofrequency ablation—uses radiowaves
The best way to prevent Barrett's esophagus is to reduce and/or treat the reflux of stomach acid into the esophagus. This is usually caused by GERD. Self-care measures for GERD include:
- Do not smoke. If you smoke, talk to your doctor about how to successfully quit.
- If you are overweight, find out how you can lose weight.
- Raise the head of your bed onto 4-6 inch blocks.
- Avoid clothes with tight belts or waistbands.
- Avoid foods that cause heartburn. These include alcohol, caffeinated beverages, chocolate, and foods that are fatty. This also includes spicy or acidic foods such as citrus or tomatoes.
- Do not eat or drink for 3-4 hours before you lie down or go to bed.
If you have GERD and at a high risk for Barrett's, talk to your doctor about a screening schedule.
National Institute of Diabetes and Digestive and Kidney Diseases
The Society of Thoracic Surgeons
GI Society—Canadian Society of Intestinal Research
Barrett esophagus. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115861/Barrett-esophagus. Updated January 18, 2016. Accessed September 15, 2016.
Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/barretts-esophagus/Pages/overview.aspx. Updated January 22, 2013. Accessed April 30, 2013.
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11/30/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG clinical guideline: diagnosis and management of Barrett's esophagus. Am J Gastroenterol. 2016;111(1):30-50.
Last reviewed March 2016 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.