Barrett’s Esophagus

Barrett’s esophagus is a condition in which the lining of the esophagus becomes damaged, usually by acid reflux, heatburn, or GERD. This damage causes the lining to thicken and become red, resembling the lining of the intestine. About 10% of those who have GERD also experience Barrett’s esophagus. There is increased risk for Barrett’s esophagus in people who have had GERD for a longer time or who developed it at a very young age. The severity of an individual case of GERD, however, does not appear to affect the risk for Barrett’s esophagus.

Risk factors for developing Barrett’s esophagus include:

  • GERD. Chronic heartburn and acid reflux is believed to be the main risk factor.
  • Family history. There is increased risk in patients with a history of Barrett’s esophagus or of esophageal cancer.
  • Race, age and gender. Barrett’s esophagus is found mostly in white patients. Men are much more likely to develop Barrett’s esophagus, as are people over the age of 50.
  • Smoking.
  • Weight. Body fat around the abdomen can increase risk.

Symptoms of Barrett’s esophagus are the same symptoms of GERD:

  • Burning sensation in the chest (commonly known as heartburn), often after eating, and occasionally worse at night
  • Feeling there is a lump in the back of the throat
  • Quick, sudden increases in saliva
  • Hoarseness or laryngitis
  • ad breath, associated with a sour or bitter taste

When GERD is worse at night, it also presents with these symptoms:

  • Chronic, unexplained dry cough
  • New or worsening asthma or similar breathing problems
  • Sleep disruption

There are also cases of Barrett’s esophagus in patients who never experienced symptoms of GERD. These patients show a condition called “silent reflux”.

When Barrett’s esophagus is suspected, physicians can perform a variety of imaging tests, including the less-invasive capsule endoscopy. Diagnosis of Barrett’s esophagus, however, can only be made during an upper endoscopy procedure. During the endoscopy, a physician will not only detect the change in the lining of the esophagus, but also take a tissue sample to confirm the diagnosis through biopsy of the affected tissue. While capsule endoscopy can provide strong evidence in video imagery, an upper endoscopy will still need to be performed for collection of a tissue sample.

Complications from Barrett’s esophagus can include dysplasia and esophageal cancer. Dysplasia is the presence of abnormal tissue cells. Dysplasia, while not necessarily cancer, can become cancer. Patients with Barrett’s esophagus do have increased risk of esophageal cancer; however this risk is small, even in cases with precancerous cells in the esophagus. However, your physician will likely screen for esophageal cancer more frequently after a diagnosis of Barrett’s esophagus.

Treatment of Barrett’s esophagus can vary, but will most likely include monitoring, possible medications, and increased screenings for esophageal cancer. Physicians may also decide to remove the enflamed, abnormal esophagus tissue through endoscopic procedures.

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