Barrett's Esophagus

Barrett’s Esophagus

WHAT IS BARRETT’S ESOPHAGUS?

Barrett’s Esophagus is a serious complication of GERD. In Barrett's esophagus, normal tissue lining the esophagus is replaced by abnormal cells that are similar to the lining of the intestine. If left untreated, these cells may become cancerous.

At Loma Linda University Health, our board-certified gastroenterology specialists can tailor strategies for treating your Barrett’s esophagus. We provide you optimal care with the most advanced technology and treatment. Our advanced technologies include double-balloon endoscopy, expanded ERCP maneuvers, and interventional endoscopy.

WHAT ARE THE SYMPTOMS OF BARRETT’S ESOPHAGUS?

Although Barrett’s esophagus causes no symptoms, it’s possible for someone with the condition to experience the symptoms of gastroesophageal reflux disease (GERD). These include:  

• Painful burning in the chest (heartburn)
• Regurgitation of food or a feeling of burning acid coming up into the throat or mouth
• Problems swallowing
• Pain in the chest that is not due to a heart condition
• A lump in the throat
• Unexplained nausea
• A cough, hoarse voice or wheezing

WHAT CAUSES BARRETT’S ESOPHAGUS?

In most cases, Barrett’s esophagus is a serious consequence of chronic, long-standing and severe gastroesophageal reflux disease (GERD). However, some people  with Barrett’s esophagus have never experienced symptoms of GERD. In these patients, the cause of Barrett’s esophagus is unknown.

Researchers do know that although Barrett’s esophagus is a pre-cancerous condition that can become cancerous, most people with Barrett’s esophagus will not develop esophageal cancer.

HOW IS BARRETT’S ESOPHAGUS DIAGNOSED?

The standard method of diagnosing Barrett’s esophagus is by using a lighted tube with a camera at the end, referred to as an endoscope. The endoscope is fed down your throat to check for signs of changing esophagus tissue. This procedure is known as endoscopy.

HOW IS BARRETT’S ESOPHAGUS TREATED?

There are a variety of options available for treating Barrett’s esophagus. These start with:

Lifestyle Changes and Medical Treatment

The medical treatment of Barrett's esophagus is similar to the treatment of GERD, starting with lifestyle changes. It will probably also include medications, called proton pump inhibitors, to block the formation of acid.

Available mostly by prescription, this group of drugs includes omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), rabeprazole (Aciphex®), esomeprazole (Nexium®) and dexlansoprazole (Dexilant®). The medication is used to prevent further damage and typically is taken 30 minutes before a meal. It is recommended that proton pump inhibitors be taken regularly to suppress acid in Barrett’s esophagus.

H2 blocker medications are not recommended for Barrett’s esophagus.

If you have been diagnosed with Barrett’s esophagus, it is very important that you take your prescribed acid suppression medication daily and have regular screening endoscopies to check for worsening disease.

If medical treatment alone doesn’t work for you, there are other options, such as endoscopic therapy or surgical therapy.

Endoscopic Therapies

There are several possible treatments that specifically focus on the abnormal tissue found in Barrett's esophagus. These include:

Radiofrequency ablation (RFA) – This therapy uses radio waves to destroy the abnormal Barrett’s cells lining the esophagus. An electrode mounted on a balloon or endoscope sends heat to the Barrett's esophageal tissue, and this destroys the cells.

Endoscopic mucosal resection (EMR) – This treatment lifts the abnormal lining and cuts it away from the wall of the esophagus. The lining is then removed through the endoscope. The goal is to remove any precancerous or cancer cells in the lining.

Cryotherapy – This is a newer technique involving freezing the tissue with liquid nitrogen.

If medical or endoscopic therapies do not work, surgical therapy may be an option.

Surgical Therapy

Although some patients with early cancer can be treated with minimally-invasive therapies such as Endoscopic Mucosal Resection (EMR), others may require surgical removal of the esophagus. After the removal, the esophagus is rebuilt from part of the stomach or large intestine.

WHAT ARE THE COMPLICATIONS OF BARRETT’S ESOPHAGUS?

Complications associated with Barrett’s esophagus include an increased risk of developing esophageal cancer.

WHO IS AT RISK FOR BARRETT’S ESOPHAGUS?

Those who suffer from gastroesophageal reflux disease (GERD) that doesn't get better when taking medications known as proton pump inhibitors, or having GERD that requires regular medication, may be at a greater risk of developing Barrett’s esophagus.

In addition, older white males are most likely to develop Barrett’s esophagus, especially if they smoke and are overweight, particularly if that weight is located mostly around their abdomen.

NEXT STEPS

• Stay aware. If you are in the risk category for GERD or Barrett’s esophagus, stay aware of the symptoms and seek medical attention immediately if you begin experiencing them.  
• Seek medical intervention. There are a variety of treatments that can address GERD or Barrett’s esophagus. To learn which one may be right for you, request an evaluation at Loma Linda University Health. Contact your provider or schedule the appointment through MyChart.