Barrett’s Esophagus

What is Barrett’s esophagus?

Barrett’s esophagus is a change in the lining of the esophagus. The esophagus is the tube that carries food from the mouth to the stomach.

If Barrett’s esophagus is not treated, sometimes it can develop into cancer. If you have Barrett's esophagus, you will need regular exams to check for cancer. Cancer of the esophagus may be prevented if Barrett’s esophagus is found, treated early, and followed up with regularly scheduled exams.

What is the cause?

Usually Barrett’s esophagus results from stomach acid that flows backward into the esophagus. This is called GER, or gastroesophageal reflux.

Everyone has reflux once in a while. Reflux usually happens after eating, especially after eating spicy foods, or from bending over soon after eating. It’s also called heartburn or acid indigestion. If you have GER more than twice every week, it can develop into gastroesophageal reflux disease (GERD) and cause Barrett’s esophagus.

What are the symptoms?

You may have symptoms of reflux. Until it is severe, Barrett’s esophagus does not cause any other symptoms. Symptoms of reflux may include:

• heartburn, which is a burning pain or warmth in your chest or throat, usually close to the bottom of the breastbone
• bitter or sour taste in the mouth
• belching
• frequent unexplained dry cough
• wheezing, shortness of breath, and chest tightness (symptoms similar to the symptoms of asthma).

A severe case of Barrett’s esophagus can cause irritation, bleeding, and scarring in the esophagus. At this severe stage it can cause symptoms, including:

• trouble swallowing
• food getting stuck in the esophagus
• weight loss

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. If your provider thinks you might have Barrett’s esophagus, you will have a procedure called endoscopy. For this exam you are given medicine to relax you. Then your provider inserts a slim, lighted, flexible tube with a tiny camera into your esophagus. Samples of any areas that look abnormal are removed (biopsied) for testing. The biopsy tests can detect Barrett’s esophagus. They can also check for cancer or any precancerous changes in the lining of the esophagus.

How is it treated?

The goal of treatment is to control reflux and keep the esophagus lining from becoming scarred or cancerous. Treatment for Barrett’s esophagus includes:

• treatment of reflux symptoms, if you have them
• endoscopic exams on a regular schedule to check for precancerous changes

Treatments for reflux include:

• antacids
• medicines that help reduce stomach acid

You will have regular checkups of your esophagus. How often you need an endoscopy exam will depend on how much the lining of your esophagus has been affected. If there are precancerous changes, the abnormal tissue will be removed. The tissue may be removed by:

• cutting the abnormal tissue away with tiny tools through an endoscope
• destroying the tissue with a laser passed through the endoscope

If the tissue is severely abnormal or has become cancer, then surgery is usually needed to remove the cancerous part of the esophagus.

How can I take care of myself?

To help keep Barrett’s esophagus from becoming cancer, follow your healthcare provider’s recommendations. This includes:

• taking medicines so you have less acid reflux
• avoiding some foods and drinks, especially chocolate, caffeine, peppermint, and fatty foods
• keeping all checkup appointments, including endoscopy exams

Things you can do to help keep acid reflux from getting worse are:

• Keep a healthy weight.
• Stop eating before you feel full.
• Raise the head of your bed to keep your head higher than your stomach when you sleep.
• Don’t smoke.
• Don’t drink a lot of alcohol.
• Do not wear clothing that is tight around the waist.
• Avoid bending over or lying down after meals.
• Avoid vigorous activity after meals.

See your healthcare provider if:

• You keep having reflux symptoms in spite of your current treatment.
• You have trouble swallowing.
• Food seems to be getting stuck in the esophagus.
• You have bloody vomit.
• You are losing weight without meaning to.