Barrett's Esophagus

Uncontrolled acid reflux can lead to serious heart burn and swallowing trouble, which leads to Barrett’s esophagus. Barrett’s esophagus is a swallowing disorder caused by normal cells in your body lining your food pipe. This disorder is commonly caused by frequent heart burn (gastroesophageal reflux disease or GERD).

At Spectrum Health, we have Barrett’s esophagus experts dedicated to the treatment of this precancerous condition. Our multispecialty team is led by gastroenterologists and includes surgeons, pathologists and nurses with expertise in medical, surgical and endoscopic management of Barrett’s Esophagus.

Treatments for Barrett's Esophagus

Without treatment, Gastroesophageal Reflux Disease (GERD) can lead to other serious issues. Diet and lifestyle changes can help reduce your symptoms. If surgery is needed for your treatment, we offer Incisionless Surgery, which is introduced through the mouth so no incisions are needed. This means shorter hospital stays, less incision pain and fewer complications after surgery.

Acid Reduction Medicine
You may be given medicine to reduce how much acid is in your stomach. Managing GERD, or acid reflux, is an important part of preventing further damage to your esophagus.

Dilation Treatment
Damage to your esophagus can cause it to narrow. We can use a tool to gently stretch (dilate) the narrow part. This widens the opening of your esophagus and brings relief to trouble swallowing.

Radiofrequency Ablation
This newer treatment uses heat wavelengths to abolish abnormal cells. As the esophagus heals, it grows back normal cells.

This surgery has a medical name of fundoplication. While surgery isn't always the first choice, this option can be worth the results. It removes the damaged tissue or part of the esophagus. What's remaining of the esophagus is then joined to the stomach.

What Is Barrett’s Esophagus?

Barrett’s esophagus is condition in which cells lining the esophagus are abnormal. The esophagus is a long muscular tube that moves food down from the mouth to the stomach. At its lower end is a small band of muscle (sphincter) that prevents stomach acid from moving back up into the esophagus (reflux). Cells called squamous (flat) cells normally line the esophagus. In Barrett’s esophagus, these cells become another type, called columnar (cells that look like columns). About 5% to 10% of people with this disorder develop cancer of the esophagus.

What Causes Barrett’s Esophagus?

The cause is unknown, but it is thought to start from chronic acid reflux disease. It can occur in 10% to 15% of people with acid reflux. It is not hereditary and is not spread from person to person.

What Are the Symptoms of Barrett’s Esophagus?

Most symptoms are similar to those in people with acid reflux or acid indigestion. Heartburn is characteristic and usually occurs at night, often waking people from sleep.

Other symptoms include chest pain, difficulty swallowing, food getting stuck or having to vomit food, shortness of breath, wheezing, laryngitis, and hoarseness.

How Is Barrett’s Esophagus Diagnosed?

The doctor usually diagnoses the disorder by using endoscopy (placing a lighted tube into the mouth and down into the esophagus). The doctor examines the esophagus and can take samples of any possible problem areas (by a biopsy, or removing a small piece of tissue for study under a microscope).

How Is Barrett’s Esophagus Treated?

The goal is to prevent acid from refluxing into the esophagus. This protects the esophageal lining and may prevent development of Barrett’s esophagus. Drugs can limit the amount of acid reaching the lining. These drugs including antacids, H2-antagonists (e.g., ranitidine, famotidine), proton pump inhibitors (e.g., omeprazole, lansoprazole), and medicines that improve gastrointestinal motion (e.g., metoclopramide). Proton pump inhibitors are most effective and preferred.

The major complication is development of esophageal cancer, but the health care provider can monitor the esophagus by frequent endoscopy to check for cancer. Other complications include bleeding from ulcers and narrowing (stricture) of the esophagus.

DOs and DON’Ts in Managing Barrett’s Esophagus:
  • DO remember that the only way to diagnose the disorder is by tissue biopsy via endoscopy. A gastroenterologist (a specialist who treats diseases of the stomach and bowel) will do this.
  • DO remember that acid reflux tends to occur more frequently at night when you lie flat. Elevating the head of the bed will help.
  • DO lose weight.
  • DO make lifestyle changes and take medicines to lower your risk of getting Barrett’s esophagus.
  • DO call your health care provider if you have heartburn that medicine doesn’t help, food gets stuck in your throat and you throw up, or you have trouble swallowing and lose weight.
  • DO call your health care provider if you vomit blood.
  • DON’T drink. Alcohol increases acid reflux.
  • DON’T eat large meals before going to bed.
  • DON’T drink coffee or eat chocolate and fats; they can increase acid reflux. Calcium channel blockers, used for high blood pressure, can also trigger reflux.

Contact the following sources:

  • American College of Gastroenterology
    Tel: (703) 820-7400
  • Gastro-Intestinal Research Foundation
    Tel: (312) 332-1350

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor