Barrett's Esophagus
Barrett's Esophagus
Definition & Facts
In this section:
- What is Barrett's Esophagus?
- Are people with Barrettâs esophagus more likely to develop cancer?
- How common is Barrettâs esophagus?
- Who is more likely to develop Barrettâs esophagus?
What is Barrett's Esophagus?
Barrettâs esophagus is a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus. Doctors call this process intestinal metaplasia.
Are people with Barrettâs esophagus more likely to develop cancer?
People with Barrettâs esophagus are more likely to develop a rare type of cancer called esophageal adenocarcinoma.
The risk of esophageal adenocarcinoma in people with Barrettâs esophagus is about 0.5 percent per year.1 Typically, before this cancer develops, precancerous cells appear in the Barrettâs tissue. Doctors call this condition dysplasia and classify the dysplasia as low grade or high grade.
You may have Barrettâs esophagus for many years before cancer develops. Visit the National Cancer Institute to learn more about esophageal adenocarcinoma.
How common is Barrettâs esophagus?
Experts are not sure how common Barrettâs esophagus is. Researchers estimate that it affects 1.6 to 6.8 percent of people.2
Who is more likely to develop Barrettâs esophagus?
Men develop Barrettâs esophagus twice as often as women, and Caucasian men develop this condition more often than men of other races.1 The average age at diagnosis is 55.3 Barrettâs esophagus is uncommon in children.3
References
Symptoms & Causes
In this section:
- What are the symptoms of Barrettâs esophagus?
- What causes Barrettâs esophagus?
- What factors increase a personâs chances of developing Barrettâs esophagus?
- What factors decrease a personâs chances of developing Barrettâs esophagus?
What are the symptoms of Barrettâs esophagus?
While Barrettâs esophagus itself doesnât cause symptoms, many people with Barrettâs esophagus have gastroesophageal reflux disease (GERD), which does cause symptoms.
What causes Barrettâs esophagus?
Experts donât know the exact cause of Barrettâs esophagus. However, some factors can increase or decrease your chance of developing Barrettâs esophagus.
What factors increase a personâs chances of developing Barrettâs esophagus?
Having GERD increases your chances of developing Barrettâs esophagus. GERD is a more serious, chronic form of gastroesophageal reflux, a condition in which stomach contents flow back up into your esophagus. Refluxed stomach acid that touches the lining of your esophagus can cause heartburn and damage the cells in your esophagus.
Between 10 and 15 percent of people with GERD develop Barrettâs esophagus.4
Obesityâspecifically high levels of belly fatâand smoking also increase your chances of developing Barrettâs esophagus. Some studies suggest that your genetics, or inherited genes, may play a role in whether or not you develop Barrettâs esophagus.
What factors decrease a personâs chances of developing Barrettâs esophagus?
Having a Helicobacter pylori (H. pylori) infection may decrease your chances of developing Barrettâs esophagus. Doctors are not sure how H. pylori protects against Barrettâs esophagus. While the bacteria damage your stomach and the tissue in your duodenum, some researchers believe the bacteria make your stomach contents less damaging to your esophagus if you have GERD.
Researchers have found that other factors may decrease the chance of developing Barrettâs esophagus, including
- frequent use of aspirin or other nonsteroidal anti-inflammatory drugs
- a diet high in fruits, vegetables, and certain vitamins
References
Diagnosis
How do doctors diagnose Barrettâs esophagus?
Doctors diagnose Barrettâs esophagus with an upper gastrointestinal (GI) endoscopy and a biopsy. Doctors may diagnose Barrettâs esophagus while performing tests to find the cause of a patientâs gastroesophageal reflux disease (GERD) symptoms.
Medical history
Your doctor will ask you to provide your medical history. Your doctor may recommend testing if you have multiple factors that increase your chances of developing Barrettâs esophagus.
Upper GI endoscopy and biopsy
In an upper GI endoscopy, a gastroenterologist, surgeon, or other trained health care provider uses an endoscope to see inside your upper GI tract, most often while you receive light sedation. The doctor carefully feeds the endoscope 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 wonât feel the biopsy. A pathologist examines the tissue in a lab to determine whether Barrettâs esophagus cells are present. A pathologist who has expertise in diagnosing Barrettâs esophagus may need to confirm the results.
Barrettâs esophagus can be difficult to diagnose because this condition does not affect all the tissue in your esophagus. The doctor takes biopsy samples from at least eight different areas of the lining of your esophagus.
Who should be screened for Barrettâs esophagus?
Your doctor may recommend screening for Barrettâs esophagus if you are a man with chronicâlasting more than 5 yearsâand/or frequentâhappening weekly or moreâsymptoms of GERD and two or more risk factors for Barrettâs esophagus. These risk factors include
- being age 50 and older
- being Caucasian
- having high levels of belly fat
- being a smoker or having smoked in the past
- having a family history of Barrettâs esophagus or esophageal adenocarcinoma
Treatment
How do doctors treat Barrettâs esophagus?
Your doctor will talk about the best treatment options for you based on your overall health, whether you have dysplasia, and its severity. Treatment options include medicines for GERD, endoscopic ablative therapies, endoscopic mucosal resection, and surgery.
Periodic surveillance endoscopy
Your doctor may use upper gastrointestinal endoscopy with a biopsy periodically to watch for signs of cancer development. Doctors call this approach surveillance.
Experts arenât sure how often doctors should perform surveillance endoscopies. Talk with your doctor about what level of surveillance is best for you. Your doctor may recommend endoscopies more frequently if you have high-grade dysplasia rather than low-grade or no dysplasia. Read whether people with Barrettâs esophagus are more likely to develop cancer.
Medicines
If you have Barrettâs esophagus and gastroesophageal reflux disease (GERD), your doctor will treat you with acid-suppressing medicines called proton pump inhibitors (PPIs). These medicines can prevent further damage to your esophagus and, in some cases, heal existing damage.
PPIs include
- omeprazole (Prilosec, Zegerid)
- lansoprazole (Prevacid)
- pantoprazole (Protonix)
- rabeprazole (AcipHex)
- esomeprazole (Nexium)
- dexlansoprazole (Dexilant)
All of these medicines are available by prescription. Omeprazole and lansoprazole are also available in over-the-counter strength.
Your doctor may consider anti-reflux surgery if you have GERD symptoms and donât respond to medicines. However, research has not shown that medicines or surgery for GERD and Barrettâs esophagus lower your chances of developing dysplasia or esophageal adenocarcinoma.
Endoscopic ablative therapies
Endoscopic ablative therapies use different techniques to destroy the dysplasia in your esophagus. After the therapies, your body should begin making normal esophageal cells.
A doctor, usually a gastroenterologist or surgeon, performs these procedures at certain hospitals and outpatient centers. You will receive local anesthesia and a sedative. The most common procedures are the following:
- Photodynamic therapy. Photodynamic therapy uses a light-activated chemical called porfimer (Photofrin), an endoscope, and a laser to kill precancerous cells in your esophagus. A doctor injects porfimer into a vein in your arm, and you return 24 to 72 hours later to complete the procedure.
- Radiofrequency ablation. Radiofrequency ablation uses radio waves to kill precancerous and cancerous cells in the Barrettâs tissue. An electrode mounted on a balloon or an endoscope creates heat to destroy the Barrettâs tissue and precancerous and cancerous cells.
Endoscopic mucosal resection
In endoscopic mucosal resection, your doctor lifts the Barrettâs tissue, injects a solution underneath or applies suction to the tissue, and then cuts the tissue off. The doctor then removes the tissue with an endoscope. Gastroenterologists perform this procedure at certain hospitals and outpatient centers. You will receive local anesthesia to numb your throat and a sedative to help you relax and stay comfortable.
Before performing an endoscopic mucosal resection for cancer, your doctor will do an endoscopic ultrasound.
Complications can include bleeding or tearing of your esophagus. Doctors sometimes combine endoscopic mucosal resection with photodynamic therapy.
Surgery
Surgery called esophagectomy is an alternative to endoscopic therapies. Many doctors prefer endoscopic therapies because these procedures have fewer complications.
Esophagectomy is the surgical removal of the affected sections of your esophagus. After removing sections of your esophagus, a surgeon rebuilds your esophagus from part of your stomach or large intestine. The surgery is performed at a hospital. Youâll receive general anesthesia, and youâll stay in the hospital for 7 to 14 days after the surgery to recover.
Surgery may not be an option if you have other medical problems. Your doctor may consider the less-invasive endoscopic treatments or continued frequent surveillance instead.
Eating, Diet, & Nutrition
How can your diet help prevent Barrettâs esophagus?
Researchers have not found that diet and nutrition play an important role in causing or preventing Barrettâs esophagus.â
If you have gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD), you can prevent or relieve your symptoms by changing your diet. Dietary changes that can help reduce your symptoms include
- decreasing fatty foods
- eating small, frequent meals instead of three large meals
Avoid eating or drinking the folâlowing items that may make GER or GERD worse:
- âchocolate
- coffee
- peppermint
- greasy or spicy foodsâ
- tomatoes and tomato products
- alcoholic drinks
Clinical Trials
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support basic and clinical research into many digestive disorders.
What are clinical trials and are they right for you?
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
What clinical trials are open?
Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
Source URL: https://www.niddk.nih.gov/health-information/digestive-diseases/barretts-esophagus/all-content
Source Agency: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Captured Date: 2016-12-19 21:04:00.0