Barrett’s esophagus is a condition in which the lining at the lower end of the esophagus is damaged by stomach acid. Normally, stomach acid is kept from splashing back up into the esophagus by the lower esophageal sphincter (LES), a muscular valve that opens and closes when you eat or drink. When the valve doesn’t work properly, you experience reflux of stomach acid, commonly known as heartburn or acid reflux.
When this irritation is severe or occurs frequently over a long period of time, it is referred to as gastroesophageal reflux disease (GERD). GERD, in turn, can cause an abnormal growth of intestinal-type cells, like those found in the stomach, to occur at the lower end of the esophagus. The abnormal growth, or dysplasia, of these cells in the area just above the LES is the distinguishing feature of Barrett’s esophagus. In rare cases, abnormal cells can result in cancer of the lower esophagus.
It is believed that the abnormal growth of intestinal-type cells in the lower esophagus is a defense mechanism against acid reflux. The cells lining the stomach are protected from contact with acid, so their presence in the esophagus may protect the normal tissue against further damage by GERD. The presence of these cells may also explain why heartburn symptoms improve in some patients with Barrett’s esophagus.
The condition occurs in males three times more often than in females and appears to be congenital (present at birth). However, current evidence is strong that in most instances, it develops as a result of longstanding GERD.
There are none. The accompanying heartburn symptoms are the result of GERD, not of the abnormal cells that characterize Barrett’s esophagus.
No. Everyone experiences mild heartburn from time to time. If the symptoms become severe or keep occurring over a long period of time, however, you should consult your doctor.
If your physician suspects Barrett’s esophagus, diagnosis requires a procedure called an upper endoscopy (EGD). This is performed while you are under sedation so that the doctor can examine the lining of the esophagus and stomach with a thin, flexible, lighted instrument called an endoscope. He or she will also collect tissue samples (biopsies) to be checked under a microscope for the presence of abnormal cells.
Barrett’s esophagus treatment includes prescription medication to reduce stomach acid production called a proton pump inhibitor (PPI) which minimizes the acid irritation to the esophagus and reduces underlying heartburn symptoms. Additionally, your doctor will perform a routine upper endoscopy with biopsies to monitor the progression of this condition – a critical step in treatment.
If pre-cancerous cells or tissue are ever discovered during these routine check-ups, advanced endoscopic techniques, such as radio frequency ablation, can remove this tissue without surgery and reduce the risk of developing esophageal cancer. To learn more, consult your gastroenterologist about these options.