Connect With A Gastroenterologist Near You









In Barrett’s esophagus, normal oesophageal epithelial cells are replaced with the metaplastic columnar cell (similar to the stomach lining).  It is believed to be due to damage from prolonged exposure of the esophagus to the reflux of gastroesophageal reflux disease (GERD). The inherent risk of progression from Barrett’s esophagus to adenocarcinoma of the esophagus has been established.

Symptoms of Barrett’s Esophagus

People with Barrett’s esophagus have no specific signs and symptoms but may experience symptoms associated with gastroesophageal reflux disease, and they include

  • A Feeling of lump in the throat
  • A burning sensation in the chest (heartburn), usually after meals and might get worse at night.
  • Chest pain
  • Difficulty swallowing food (dysphagia).
  • Regurgitation of digested food and sour liquid

What causes Barrets’s Esophagus

The exact cause of Barrett’s esophagus is unknown. However, it is believed by experts to be a serious complication of a chronic or longstanding gastrointestinal reflux disease (GERD). GERD is a condition in which the stomach contents flow back into the esophagus, damaging the cells and tissues that line the interior. As the esophagus makes an effort to heal itself, the esophagus cells are replaced with another cell type found in the stomach

Factors that increase the risk of Barrett’s esophagus include

  • The long history of heartburn and acid reflux. Having GERD that doesn’t get better when taking medications known as proton pump inhibitors or having GERD that requires regular medication can increase the risk of Barrett’s esophagus.
  • Barrett’s esophagus can occur at any age but is more common in older adults.
  • Men are far more likely to develop Barrett’s esophagus than in women of the same age.
  • White Caucasians people have a higher risk of the disease than do people of other races.
  • Pregnancy
  • Scleroderma, a connective tissue disorder that causes thickening of blood vessels, skin, muscles and internal organs.
  • Being overweight. Body fat around your abdomen further increases your risk.
  • Current or history of smoking.

Likewise, there are factors decreases your risk of developing Barrett’s esophagus and they include

  • Frequent use of aspirin or other nonsteroidal anti-inflammatory drugs such as ibuprofen
  • A diet rich in fruits, vegetables, and certain vitamins

Can Barrett’s esophagus be treated?

Barrett’s esophagus is diagnosed using an upper gastrointestinal endoscopy with a biopsy.

To perform an upper gastrointestinal endoscopy, a gastroenterologist, surgeon, or other trained health care provider uses an endoscope (a long flexible tube with a camera attached) to view the inside of your upper GI tract, most often while you receive light sedation. The doctor carefully guides the flexible tube down your esophagus and into your stomach and duodenum. The procedure may show changes in the lining of your esophagus.

The doctor performs a biopsy with the endoscope by taking a small piece of tissue from the lining of your esophagus. You won’t feel the biopsy. A sample of the tissue is viewed in the lab by a pathologist to determine whether pre-cancerous cells or cancer cells are present.  If the biopsy confirms the presence of Barrett’s esophagus (no dysplasia), your doctor will probably recommend a periodic follow-up endoscopy and biopsy to examine more tissue for early signs of developing cancer. If precancerous cells (low-grade dysplasia) are present in the biopsy, your doctor will discuss treatment and surveillance options with you.

Barrett’s esophagus can be challenging to diagnose because this condition does not affect all the cells lining your esophagus. The doctor takes biopsy samples from at least eight different areas of the lining of your esophagus.

The American College of Gastroenterology says men who have had a history of gastroesophageal reflux disease symptoms at least weekly that don’t respond to proton pump inhibitor medication, and who have no less than two more risk factors may be recommended for a screen. These factors include

  • Being a Caucasian.
  • Over the age of 50 years
  • Overweight and having a lot of abdominal fat
  • Having a family history of Barrett’s esophagus or esophageal cancer.
  • A history of smoking or current smoker

 

Can Barrett’s esophagus be treated?

The treatment options for Barrett’s esophagus depends on the degree of abnormal cell growth found during biopsy, age, and overall health. Treatment options include medications, endoscopic mucosal resection, endoscopic ablative therapies, and surgery.

Medications

These drugs are used to treat symptoms of gastroesophageal reflux disease. The work by suppressing acid production in the stomach, prevent further damage to the epithelial lining of the esophagus and promote healing to existing damage. These drugs are known as PPIs (Proton pump inhibitors) and include omeprazole, lansoprazole, esomeprazole, and pantoprazole.

Endoscopic mucosal resection

In endoscopic mucosal resection, a small section of the mucosal tissue is cut off using an endoscope. This procedure is performed by a Gastroenterologist. Complications such as bleeding or esophageal tear may arise. It is sometimes combined with photodynamic therapy.

Surgery

Esophagectomy is an alternative to endoscopic procedures; Esophagectomy is the surgical removal of the affected section of esophagus. After the section is removed, the surgeon reconnects your esophagus using a part of the stomach, or large intestine. This procedure carries so many complications and is the least preferred.

 

Certain lifestyle modification can help improve symptoms of gastroesophageal reflux disease which are central to Barrett’s esophagus

  • Avoid certain foods or drinks that aggravate your heartburn, such as coffee, mint, alcohol, chocolate, oily or fatty foods, tomatoes and tomato products
  • Maintain a healthy weight. Being overweight increases your risk of having a reflux
  • Avoid sleeping immediately after meals. Wait for at least three hours.
  • Avoid smoking.
  • Sleep with the bed head elevated using a pillow.

Connect With A Gastroenterologist Near You









References

Bland, K. (2006). The Frequency of Barrett’s Esophagus in High-Risk Patients With Chronic GERD. Yearbook Of Surgery2006, 231-233. doi: 10.1016/s0090-3671(08)70485-3

Fan, X., & Snyder, N. (2008). Prevalence of Barrett’s Esophagus in Patients with or without GERD Symptoms: Role of Race, Age, and Gender. Digestive Diseases And Sciences54(3), 572-577. doi: 10.1007/s10620-008-0395-7

JONES, T. (2001). Prevalence of typical (esophageal) and extraesophageal GERD symptoms in patients with Barrett? S esophagus. The American Journal Of Gastroenterology96(9), S18. doi: 10.1016/s0002-9270(01)02779-4

Roberts, J., Aravapalli, A., Pohl, D., Freeman, J., & Castell, D. (2012). Extraesophageal gastroesophageal reflux disease (GERD) symptoms are not more frequently associated with proximal esophageal reflux than typical GERD symptoms. Diseases Of The Esophagus25(8), 678-681. doi: 10.1111/j.1442-2050.2011.01305.x