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Barrett's Esophagus

What is Barrett’s Esophagus?

Barrett’s 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 .

People with Barrett’s esophagus are more likely to develop a rare type of cancer called esophageal adenocarcinoma.The risk of esophageal adenocarcinoma in people with Barrett’s esophagus is about 0.5 percent per year. Typically, before this cancer develops, precancerous cells appear in the Barrett’s tissue. Doctors call this condition dysplasia and classify the dysplasia as low grade or high grade. You may have Barrett’s esophagus for many years before cancer develops. Visit the National Cancer Institute to learn more about esophageal adenocarcinoma

Experts are not sure how common Barrett’s esophagus is. Researchers estimate that it affects 1.6 to 6.8 percent of people. Men develop Barrett’s esophagus twice as often as women, and Caucasian men develop this condition more often than men of other races. The average age at diagnosis is 55. Barrett’s esophagus is uncommon in children.

symptoms

While Barrett’s esophagus itself doesn’t cause symptoms, many people with Barrett’s esophagus have gastroesophageal reflux disease (GERD), which does cause symptoms.

causes

Experts don’t know the exact cause of Barrett’s esophagus. However, some factors can increase or decrease your chance of developing Barrett’s esophagus. Having GERD increases your chances of developing Barrett’s 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.

Obesity—specifically high levels of belly fat—and smoking also increase your chances of developing Barrett’s esophagus. Some studies suggest that your genetics, or inherited genes, may play a role in whether or not you develop Barrett’s esophagus.

RISK factors

Having a Helicobacter pylori (H. pylori) infection may decrease your chances of developing Barrett’s esophagus. Doctors are not sure how H. pylori protects against Barrett’s 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 Barrett’s esophagus, including

  • frequent use of aspirin or other nonsteroidal anti-inflammatory drugs
  • a diet high in fruits, vegetables, and certain vitamins
DIAGNOSIS

Doctors diagnose Barrett’s esophagus with an upper gastrointestinal (GI) endoscopy and a biopsy. Doctors may diagnose Barrett’s esophagus while performing tests to find the cause of a patient’s gastroesophageal reflux disease (GERD) symptoms.

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 Barrett’s esophagus.

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 won’t feel the biopsy. A pathologist examines the tissue in a lab to determine whether Barrett’s esophagus cells are present. A pathologist who has expertise in diagnosing Barrett’s esophagus may need to confirm the results.

Barrett’s 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.

SCREENING
Your doctor may recommend screening for Barrett’s esophagus if you are a man with chronic—lasting more than 5 years—and/or frequent—happening weekly or more—symptoms of GERD and two or more risk factors for Barrett’s 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 Barrett’s esophagus or esophageal adenocarcinoma