HomeHealth articlesbarrett's esophagusWhat Is Barrett’s Esophagus?

Barrett’s Esophagus - Causes, Symptoms, Diagnosis, and Treatment

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Barrett's esophagus is a condition in which there is a change in the cells lining the esophagus. Read the article to know more about Barrett's esophagus.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Jagdish Singh

Published At September 9, 2022
Reviewed AtApril 24, 2023

Introduction:

The esophagus is the tube that carries food from the mouth to the stomach. In Barrett's esophagus, normal tissue cells lining the esophagus change like intestine cells. It is more common in people with gastroesophageal reflux disease (GERD). As a result, Barrett's has an increased risk of developing esophageal cancer. The condition is named after the surgeon Norman Barrett.

What Causes Barrett's Esophagus?

The exact cause of Barrett's esophagus is not known. However, this condition is often seen in gastroesophageal reflux disease (GERD) patients. It occurs when the lower esophageal sphincter muscle weakens or is damaged and does not prevent the stomach acid from back flowing into the esophagus. Barrett's esophagus can also develop without gastroesophageal reflux disease. Approximately five to ten percent of the people with GERD develop Barrett's esophagus. It affects men twice more than women.

Who Is at Risk for Barrett's Esophagus?

People who are more likely to develop Barrett's esophagus are:

  • Male are more likely to be affected.

  • Middle-aged and older adults are at high risk.

  • Obese people.

  • Family history of Barrett's esophagus or esophageal cancer.

  • Chronic heartburn symptoms.

  • Gastroesophageal reflux disease (GERD).

Factors aggravating gastroesophageal reflux disease (GERD) can worsen Barrett's esophagus. Those include:

  • Smoking.

  • Alcohol.

  • Frequent use of non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin.

  • Eating large portions of food.

  • Fatty food.

  • Spicy food.

  • Going to bed immediately after eating.

What Are the Symptoms of Barrett's Esophagus?

Barrett's esophagus does not show any symptoms. However, heartburn and acid reflux are the symptoms that can signal Barrett's esophagus.

Other symptoms include:

  • Heartburn that worsens or wakes you from sleep.

  • A sensation of food stuck in the esophagus.

  • Painful or difficult swallowing.

  • Unexplained weight loss.

  • Blood in stool.

  • Vomiting.

  • Sore throat.

  • Bad breath.

How Is Barrett's Esophagus Diagnosed?

The only way to confirm the diagnosis of Barrett's esophagus is with an upper endoscopy.

This involves inserting a thin, flexible tube attached to a camera through the throat into the esophagus. The endoscope is used to look for changes in the esophagus lining. Normal esophagus lining appears pale and glossy, whereas the tissue appears red and velvety in Barrett's esophagus. The diagnosis is confirmed by taking tissue samples (biopsy) from the lining of the esophagus and analyzed in the laboratory. The tissue is examined to determine the degree of change.

Determining the Degree of Tissue Change:

The tissue change is classified as:

  • No Dysplasia: No precancerous changes are found in the cells.

  • Low-Grade Dysplasia: Small signs of precancerous changes.

  • High-Grade Dysplasia: Cells show many changes. High-grade dysplasia can change into esophageal cancer.

What Is the Anatomy and Histology of Barrett's Esophagus?

The esophagus is normally lined by stratified squamous epithelium. Barrett's esophagus results from a metaplastic conversion of the normal squamous epithelium of the esophagus to columnar epithelium with goblet cells.

What Is the Screening for Barrett's Esophagus?

Screening is recommended for men who have gastroesophageal reflux symptoms that do not respond to medications like proton pump inhibitors and who have at least two more risk factors, including:

  • Being male.

  • Being white.

  • Being over 50 years of age.

  • Having a family history of Barrett's esophagus or esophageal cancer.

  • Being a current or past smoker.

  • Obese.

What Is the Treatment of Barrett's Esophagus?

The treatment depends upon the symptoms and dysplasia on biopsies.

  • Barrett's Esophagus Without Dysplasia:

Barrett's esophagus without dysplasia means precancerous cells are absent. Usually, no treatment is needed at this stage therefore, continuous monitoring with an upper endoscopy is followed. Upper endoscopy is done every two or three years to look for changes in the lining cells. If gastroesophageal reflux disease (GERD) is present, medications are prescribed to treat the symptoms. Medications include H2 receptor antagonists and proton pump inhibitors. These medications decrease stomach acid. Lifestyle changes can also help in relieving the symptoms. For example, eating meals at regular intervals, dinner two hours before bed, and sleeping in a slightly inclined position can also help.

  • Barrett's Esophagus With Dysplasia:

Dysplasia is the presence of cancerous cells. Therefore, frequent monitoring is followed to prevent cancer from developing.

  • Low-Grade Dysplasia: Low-grade dysplasia indicates the presence of some abnormal cells. Frequent monitoring and follow-up are needed in these cases. Upper endoscopy is done every six months to a year. Ablation therapy is also recommended in some patients.

  • High-Grade Dysplasia: High-grade dysplasia indicates the presence of abnormal cells in the esophagus lining. Cancer is highly associated in these cases. Upper endoscopies are repeated more often to look for cancer.

The treatment for removing the damaged tissue includes:

  • Radiofrequency Ablation: This is the most common procedure. It kills the abnormal tissue using radio waves which generate heat.

  • Cryotherapy: Liquid nitrogen is used to freeze the damaged tissues of the esophageal lining.

  • Photodynamic Therapy: This uses light to destroy precancerous cells. First, the cells are sensitized with medication and then exposed to light using an endoscope.

  • Endoscopic Mucosal Resection: Precancerous spots on the esophageal lining are removed using an endoscope.

  • Surgery: Esophagectomy is surgery to remove all or part of the esophagus; it is done in severe dysplasia or esophageal cancer cases.

What Are the Complications?

Possible complications of these procedures include narrowing of the esophagus, cuts or rupture in the esophagus, and chest pain.

How to Prevent Barrett's Esophagus?

People with untreated heartburn are more likely to develop Barrett's esophagus. In addition, untreated heartburn raises the risk of esophageal adenocarcinoma by 64 times. Avoid drinking alcohol, smoking, and maintaining a healthy weight can prevent the irritation of the esophagus.

Conclusion:

Barrett's esophagus is a serious complication of gastroesophageal reflux disease. Patients diagnosed with Barrett's esophagus can live a normal life. This condition is treatable and does not hold the risk of death. However, regular endoscopy is recommended to detect precancerous changes because of the increased risk of esophageal cancer.

Frequently Asked Questions

1.

Is Barrett’s Esophagus a Serious Condition?

Barrett's Esophagus is a potentially serious condition as it increases the risk of developing esophageal cancer, although not everyone with Barrett's Esophagus will develop cancer.

2.

Does the Presence of Barrett’s Esophagus Indicate the Presence of Cancer?

Barrett's Esophagus does not necessarily indicate the presence of cancer, but it is considered a precancerous condition due to the increased risk.

3.

Can Barrett’s Esophagus Be Treated Naturally for Healing?

Medical attention is required since Barrett's oesophagus is considered a potentially precancerous condition. No known natural treatments will reverse the disease, although some natural therapies, such as peppermint oil or ginger tea, may be useful for treating symptoms.

4.

What Are the Most Effective Methods for Healing Barrett’s Esophagus?

The most effective methods for healing Barrett's Esophagus include medication to reduce acid reflux, endoscopic procedures to remove abnormal cells, and regular surveillance to monitor cancer development.

5.

How Can I Naturally Repair My Esophagus?

Naturally-reducing the esophagus is impossible, but adopting healthy lifestyle habits such as maintaining a balanced diet, managing weight, and avoiding triggers like smoking and alcohol can support overall esophageal health.

6.

Is It Possible to Live a Normal Life With Barrett’s Esophagus?

Many individuals with Barrett's Esophagus can lead a normal life with proper management, including regular monitoring and treatment.

7.

Are There Specific Foods That Promote Healing of Barrett’s Esophagus?

While no specific foods are known to directly promote the healing of Barrett's Esophagus, a healthy diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products can support overall esophageal health.

8.

At What Age Does Barrett’s Esophagus Typically Occur?

Barrett's Esophagus typically occurs in individuals over 50, but it can occur at any age.

9.

What Are the Methods Used to Detect Barrett’s Esophagus?

Methods to detect Barrett's Esophagus include endoscopy with biopsies, imaging tests like upper gastrointestinal series or barium swallow, and specialized tests like chromoendoscopy or confocal laser endomicroscopy.

10.

Can I Consume Milk if I Have Barrett’s Esophagus?

Milk consumption may vary depending on individual tolerance. However, most evidence indicates that milk, particularly full-fat milk, may exacerbate symptoms.

11.

Does Vitamin C Have Any Benefits for Barrett’s Esophagus?

While vitamin C is generally beneficial for overall health, no specific evidence suggests direct benefits of vitamin C for Barrett's Esophagus. However, it was recently observed that 35 % of individuals with Barrett's esophagus who received vitamin C supplements showed a down-regulation of activated NF-B and cytokines.

12.

Can a Biopsy Confirm the Presence of Barrett’s Esophagus?

A biopsy is the gold standard for confirming the presence of Barrett's Esophagus, as it involves the examination of tissue samples under a microscope.

13.

Is Pantoprazole an Effective Treatment for Barrett’s Esophagus?

For the treatment of Barrett's esophagus, pantoprazole has received a mean rating of 5.8 out of 10 from 20 reviews. 35 % of reviewers had unfavorable experiences, while 45 % said they had positive ones.
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Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology

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