Regional Gastrointestinal Consultants

Barrett's Esophagus

Barrett's Esophagus

Barrett’s Esophagus

Overview

Barrett’s Esophagus is a condition which affects the lower esophagus. It is named after the doctor who first described it. In Barrett’s esophagus, the cells that line the affected area of esophagus become changed. Another name sometimes used by doctors for Barrett’s esophagus is columnar-lined esophagus (CLO).

Barrett’s Esophagus is when the lining of the esophagus changes and becomes more like the lining of the small intestine. This change occurs just above the area where the esophagus is joined to the stomach.

Experts believe that Barrett’s esophagus is caused by chronic inflammation related to Gastroesophageal Reflux Disease (GERD). GERD occurs when contents in the stomach flow back up into the esophagus due to the valve between the stomach and esophagus not closing properly.

Symptoms

There are no particular symptoms for Barrett’s Esophagus. Barrett’s Esophagus is suspected when there are symptoms of persistent gastric reflux or symptoms of complicated reflux. These symptoms include:

  • Persistent heartburn
  • Difficulty swallowing
  • Painful swallowing
  • Vomiting
  • Weight loss
  • A sensation of fullness during eating.
  • Feeling sick (nauseated).
  • An acid taste in the mouth.
  • Bloating.
  • Belching.
  • A burning pain when you swallow hot drinks.

Treatment

The ideal prevention is to treat gastro-esophageal reflux before it leads to Barrett’s Esophagus. Patients with proven Barrett’s Esophagus are usually treated with proton pump inhibitor medication such as omeprazole, esomeprazole, pantoprazole, and rabeprazole, or sometimes with surgery.

Barrett’s Esophagus can only be diagnosed at endoscopy and confirmed by taking biopsies (tiny samples of tissue). Once Barrett’s esophagus has been diagnosed, regular examinations (every two to three years) are needed to check for dysplasia. Dysplasia is a further microscopic change in the cells that is recognizable in the biopsy and indicates a high risk of cancer. In this situation, endoscopies need to be performed more frequently (every six months). 

Treatment Includes

  • Medications – once Barrett’s Esophagus has been diagnosed, it is essential that treatment is given to eliminate acid reflux. The typical medications used are lansoprazole, omeprazole and pantoprazole. These are very effective at eliminating symptoms of reflux. Specialists treating this condition may need to check the effectiveness of any medications, using 24-hour pH monitoring.

  • Endoscopic therapy – if severe dysplasia or carcinoma is found, this can sometimes be removed with microsurgery performed using an endoscope.

  • Surgery – an anti-reflux operation can be performed. This is usually only done if the medications are ineffective. If cancerous cells or severe dysplasia has been detected, the lower esophagus will need to be surgically removed.

Diet Management

The diet for patients with Barrett Esophagus is the same as that recommended for patients with GERD. Patients should avoid the following:

  • Fried or fatty foods
  • Chocolate
  • Peppermint
  • Alcohol
  • Coffee
  • Carbonated beverages
  • Citrus fruits or juices
  • Tomato sauce
  • Ketchup
  • Mustard
  • Vinegar
  • Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs)

Management Includes

Once Barrett Esophagus has been identified, patients should undergo periodic surveillance endoscopy to identify histologic markers for increased cancer risk (dysplasia) or cancer that is at an earlier stage and is amenable to therapy. Dysplasia is the best histologic marker for cancer risk.

  • The management options for high-grade dysplasia include the following:
  • Surveillance endoscopy, with intensive biopsy at 3-month intervals until cancer is detected
  • Endoscopic ablation: Ablation is first-line therapy
  • Surgical resection: While studies have shown surgery to be efficacious in the control of GERD symptoms, no good evidence indicates that surgical therapy provides regression in Barrett esophagus

IMPORTANT HEALTH NOTE

We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.