What is Barrett's Esophagus?

Barrett's esophagus is a relatively silent, uncommon disease that can be a precursor to several serious conditions. Although anyone can develop it, those at higher risk are men, Caucasians, Hispanics and senior citizens. One out of ten people that experience gastroesophageal reflux disease (GERD) will develop Barrett's esophagus.

Little is known about the transformation, or metaplasia, that occurs in the tissue lining of the esophagus that results in Barrett's esophagus. The squamous (flat) cells of the esophagus change into columnar (column-shaped) cells. Of the three possible types of columnar cells that can develop in the esophagus, one is recognized as those found in the small intestine. This particular type of intestinal cell is known as Barrett's esophagus and has the potential of developing into cancer.

Though there is speculation as to why Barrett's esophagus develops into these columnar cells, most researchers believe that damaged squamous cells cause the transformation. Chronic acid reflux, or its successor, GERD, produces stomach acids that burn the lining of the esophagus. This transformation is initiated during the healing and the new cells exhibit columnar characteristics.

The sphincter muscle at the juncture of the esophagus and stomach keeps acids in the stomach to digest the food. A weakened sphincter or a hiatal hernia permits these acids to backwash into the esophagus. Based on genetics, some people are predisposed to the condition. With the lifestyle and acidic diets of Western civilization, many in our society have experienced heartburn from time to time. GERD is a more complex condition causing these acids to backwash into the esophagus more consistently, resulting in damage to the tissue.

Symptoms of GERD include excessive acid reflux, belching, coughing, difficulty swallowing, chronic heartburn, regurgitation of food, sore throat, hoarseness and breathing problems. This chronic regurgitation of acids into the lower esophagus is what exposes the tissues. It is recommended that you seek medical advice if any of these symptoms become persistent for an extended period.

Barrett's esophagus has no subjective symptoms. An upper gastrointestinal endoscopy is the only way to properly diagnose the condition. The lining of the esophagus and stomach is observed by inserting a flexible telescope down the esophagus. A biopsy is taken for examination to confirm the condition. Through the endoscopy, verification is also made by the visual salmon red appearance of the esophagus, which normally is pale pink in color.

People diagnosed with Barrett's esophagus have a higher than average risk of developing cancer of the esophagus. This is the reason it is important to explore the possibility if the patient has chronic GERD or other complications from acid reflux. It is recommended that surveillance endoscopies be repeated with one to three year intervals.

Most patients who are diagnosed with Barrett's esophagus are being treated for acid reflux or GERD. These treatments do not reverse the columnar cells but will help prevent further erosion of healthy tissue. In the early 2000’s, experimental treatments began burning these columnar cells with laser surgery in the hopes that the healing process would reverse the cells back to their original state.

Home treatments of Barrett's esophagus involve lifestyle and diet changes. Losing weight, quitting smoking, eating smaller, more frequent meals, avoiding acidic foods that trigger heartburn, finding a good antacid or herbal remedy that relieves your acid reflux, elevating your head while sleeping, avoiding bending or stooping and wearing loose clothing are good options that can relieve the symptoms of GERD and reduce acid production.

Most people who have Barrett's esophagus and GERD require treatments that are more aggressive. Prescription medications, surgery to tighten the sphincter, laser surgery of the damaged tissue or partial or complete removal of the esophagus is a final option. In extreme cases where the patient shows a high rate of abnormal cells (dysplasia), removal of the esophagus is recommended. If high levels of dysplasia are detected, it can be an indication that cancer is already present.