AMITA Health Endoscopy Center Lincoln Park

Barrett’s Esophagus

Overview

Barrett’s esophagus is a condition in which the inner lining of the esophagus becomes red and thickened from chronic acid reflux from the stomach into the esophagus. The esophagus is the muscular tube that connects your mouth to your stomach.

Chronic acid reflux into the esophagus is also called GERD (gastroesophageal reflux disease). Chronic GERD can cause changes in the cells of the lining of the esophagus, changing them into precancerous cells (dysplasia). Regular exams are important since these precancerous cells can be treated. Regular endoscopy and biopsy are needed to closely watch these cells. Endoscopy involves a tube with a camera that is lowered down into the esophagus to view the lining and take a tissue sample (biopsy). A pathologist will check the biopsy tissue for these precancerous cells.

Risk factors for Barrett’s esophagus are being overweight, smoking, chronic GERD and a family history of Barrett’s or esophageal cancer. White males are the most likely group to develop Barrett’s esophagus.

Though the risk of developing esophageal cancer is small, treating these precancerous cells can help prevent cancer from forming. Treatment involves resection or ablation (destroying) of these irregular cells.

Symptoms

  • Heartburn and chest pain
  • *Please seek immediate medical attention with chest pain, especially with arm pain or shortness of breath
  • Trouble swallowing food (dysphagia)
  • Upper abdominal pain
  • Dry cough

Treatments

No dysplasia. Your doctor will probably recommend typical treatments for GERD – lifestyle changes and acid-suppressing medications such as proton pump inhibitors or PPIs. Omeprazole (Prilosec) is an example of a PPI. Other acid-suppressing medications include H-2 blockers such as famotidine (Pepcid). Lifestyle changes include quitting smoking, losing weight, avoiding lying down after eating and raising the head of your bed. If medications do not help sufficiently, endoscopy or surgery can help control the flow of stomach acid into the esophagus.

Low-grade dysplasia. Low-grade dysplasia is the precancerous stage in the esophageal lining cells. Your doctor may recommend following the dysplasia with endoscopies every six months as a conservative approach. But considering your medical and family history, a treatment plan may be advised. The precancerous or dysplastic cells may be resected with an endoscope. Other options include ablation (destroying) of these irregular cells using heat (radiofrequency) or cold (cryotherapy) during an endoscopy.

High-grade dysplasia. These high-grade cells can also be resected or removed with an endoscope. Badly dysplastic cells can also undergo ablation with radiofrequency or cryotherapy during an endoscopy. Another surgical option is removing the severally damaged portion of your esophagus and reattaching the remaining section to your stomach. These approaches are critical to best try and avoid esophageal cancer development.

Prevention

Avoid GERD-triggering foods and drinks. Alcohol, fatty foods, tomato sauce, chocolate, caffeine and certain other foods can worsen your symptoms. Avoid these foods that typically trigger your heartburn.

Elevate the head of your bed. Many patients experience worsening of their symptoms at night. If so, elevating the head of your bed may help. A common way to achieve this is using a wedge between your box spring and mattress. Elevating your head at night can make gravity your friend by keeping acid in your stomach and out of your esophagus.

Establish or maintain a healthy weight. Extra pounds around the abdomen can push up your stomach and force acid into your esophagus, worsening your symptoms. Ask your provider for a weight loss and exercise plan that matches your needs.

Stop smoking.