Barrett's Esophagus

What is Barrett's Esophagus?

Long-term gastroesophageal reflux disease (GERD) can sometimes lead to Barrett's esophagus, a condition in which the color and composition of the cells lining your lower esophagus change because of repeated exposure to stomach acid. Having Barrett's esophagus increases your risk of developing esophageal cancer.

Only a small percentage of people with GERD develop Barrett's. But once it's diagnosed, there's a much greater risk of developing esophageal cancer, which often spreads from the esophagus to lymph nodes and to other organs.

Symptoms and Signs of Barrett's Esophagus

There are no specific symptoms associated with Barrett's esophagus itself, but heartburn and acid reflux (the bad-tasting liquid that may enter your mouth from your throat) are common indicators of GERD. And having GERD can lead to Barrett's esophagus.

A reavealing sign of Barrett's esophagus occurs when the color of the tissue lining the lower esophagus changes from its normal pink to a salmon color. This process, called metaplasia, is caused by repeated and long-term exposure to stomach acid.

Other signs and symptoms of GERD that also may be associated with Barrett's esophagus or even rarely esophageal cancer include:

Trouble swallowing. Often, a narrowing of the esophagus (esophageal stricture) leads to difficulty swallowing (dysphagia).
Bleeding. You may vomit red blood or blood that looks like coffee grounds.
Unusual stools. Your stools may be black, tarry or bloody.
Sudden weight loss. You may experience an unexpected drop in weight.

If you experience any of these symptoms, contact your doctor immediately.

Causes of Barrett's Esophagus

Barrett's esophagus usually develops from GERD. Heartburn and acid reflux are the most common symptoms of GERD and result from stomach contents washing into the esophagus and irritating it.

Diagnosing Barrett's Esophagus

Diagnosing Barrett's esophagus is difficult because it often doesn't exhibit specific symptoms. Experiencing the acid reflux of GERD may be the best indication that you either have Barrett's esophagus or may be at risk to acquire the disease.

If you have severe acid reflux, your doctor may discover Barrett's esophagus by examining your esophagus through insertion of a lighted, flexible tube (endoscope) with a camera on its tip through your mouth and into your esophagus and stomach. The procedure allows your doctor to search for abnormalities such as precancerous cell changes (dysplasia) or an abnormal junction between your stomach and esophagus. In a healthy esophagus, the stomach-esophagus mucosal junction is at the lower end of the esophagus. In Barrett's esophagus, this junction is displaced upward. If Barrett's esophagus is suspected, your doctor also looks for evidence of cancer.

During endoscopy, your doctor may remove tissue samples (biopsies) of potentially abnormal areas to be examined under a microscope. If specimens reveal intestinal goblet-shaped cells, your doctor may make a diagnosis of Barrett's esophagus.

Treating Barrett's Esophagus

Treating Barrett's esophagus may start with controlling GERD by making a number of lifestyle changes and taking self-care steps. These include:

Getting more exercise
Losing weight
Avoiding foods that aggravate heartburn
Stopping smoking if you smoke
Taking antacids or stronger acid blocking medications
Elevating the head of your bed to prevent reflux during sleep

People with severe GERD and Barrett's esophagus usually need aggressive treatment, which may include medications, other nonsurgical medical procedures, or even surgery.

It's not too late to treat Barrett's esophagus if you don't have advanced cancer. However, many people with esophageal cancer show up so late in the progress of the disease that doctors discover Barrett's esophagus at the same time they find the cancer.