Barrett's esophagus refers to the serious complication that sometimes occurs when someone has gastroesophageal reflux, also known as GERD.
Approximately 10% of GERD patients develop Barrett's esophagus.
Causes
The chronic contact between stomach contents and esophageal cells results in a transformation. Over time, normal cells are replaced with the type of cells found in the intestines. This alteration increases the risk of developing esophageal adenocarcinoma, a serious form of cancer. However, fewer than 1% of people with Barrett's esophagus progress to the cancerous stage. Once diagnosed with Barrett's, patients must undergo routine monitoring. Finding malignant growths at an early stage makes treatment easier and prevents possible metastasis and terminal outcomes.
Symptoms
Any Barrett's esophagus symptoms experienced are usually directly related to the GERD diagnosis. GERD occurs when stomach contents and acid flow backward, or reflux, into the esophagus. When this happens, patients often suffer frequent bouts of heartburn, burning sensations in the back of the throat, nausea, and a chronic cough. The condition may lead to laryngitis.
Risk Factors
Anyone suffering from GERD is at risk for developing Barrett's. However, the condition seems more prevalent in white males with a lasting history of GERD. Other risk factors include:
- Early onset of GERD
- Having a hiatal hernia
- Being overweight, particularly around the midsection
- Being over the age of 50
- Having a current or past history of smoking
Diagnosis
The American Gastroenterological Association recommends screening for Barrett's esophagus when patients have multiple risk factors. Physicians often make a diagnosis following an upper endoscopic procedure and tissue biopsy. The endoscopic evaluation involves inserting a long, flexible tube equipped with a camera down the esophagus. Using this device, a gastroenterologist visualizes the esophageal lining and retrieves a small sample of the lining cells. A laboratory then identifies the type of cells and assesses them for possible abnormalities.
Treatment
Physicians typically recommend routine endoscopic monitoring as a precautionary measure. Depending on the stage of cellular alteration, the goal remains to slow or inhibit further changes. These preventative measures basically entail lifestyle changes that include:
- Eliminating caffeine, chocolate, fatty foods, peppermint, spicy foods
- Avoiding alcoholic beverages and tobacco
- Losing weight
- Elevating the head of the bed
- Remaining upright for three hours after eating
- Taking prescribed medications with a full glass of water
Medications Prescribed for GERD and Barrett's:
- Antacids to neutralize stomach acid
- Proton pump inhibitors to reduce stomach acid production
- H2 blockers to inhibit stomach acid release
- Promotility agents to decrease the time it takes for food to travel to the stomach and intestines
There are several invasive procedures designed to eliminate abnormal tissue from the esophagus. Photodynamic therapy, or PDT, is a laser-assisted form of endoscopy that kills the abnormal cells without harming normal tissue.
Endoscopic mucosal resection, or EMR, is another option. This endoscopic procedure involves cutting the abnormal lining and removing larger portions of tissue from the esophagus in hopes of removing possible cancerous cells. If cancer is suspected, an ultrasound analysis determines if the malignancy has spread into the esophagus. In the event of cancer, surgeons remove the damaged portion of the esophagus.
