Barrett’s Esophagus

Barrett’s esophagus is a condition in which frequent exposure to stomach acid from reflux causes the normal tissue lining the esophagus (tube that carries food from the mouth to the stomach) to change so that it resembles the lining of the intestine. In a small number of people, this abnormal tissue can lead to precancerous changes and puts people at an increased risk for esophagus cancer.

GERD is the primary risk factor of Barrett's esophagus.

How is Barrett’s esophagus diagnosed?

With no specific symptoms, Barrett’s esophagus Barrett's esophagus can only be diagnosed with an upper endoscopy and biopsy. This esophagus exam is used to detect precancerous and cancerous cells early, when the disease is easier to treat.

How is Barrett’s esophagus treated?

In some cases, lifestyle changes and medication designed to treat/control acid reflux are recommended to prevent or slow the development of Barrett’s esophagus. For others, surgery might be a more effective solution.

LIFESTYLE CHANGES:

  • Avoid fatty foods, chocolate, caffeine, spicy foods, and peppermint, which aggravate reflux.
  • Avoid alcohol, caffeinated drinks, and tobacco.
  • Lose weight, as being overweight increases your risk for reflux.
  • Sleep with the head of the bed elevated to prevent the acid in your stomach from flowing up into the esophagus.
  • Don't lie down for 3 hours after eating.
  • Take all medicines with plenty of water.

MEDICATIONS:

  • Proton pump inhibitors that reduce the production of stomach acid
  • Antacids to neutralize stomach acid
  • H2 blockers that lessen the release of stomach acid

SURGERY:

  • Radiofrequency ablation (RFA) uses radio waves delivered through an endoscope in the esophagus to destroy only the abnormal cells.
  • Photodynamic therapy (PDT) requires a patient to ingest Photofrin, which makes cells light-sensitive. Then a laser is used through an endoscope to kill only abnormal esophagus cells.
  • Endoscopic spray cryotherapy is a newer technique that freezes the abnormal cells by applying cold nitrogen or carbon dioxide gas through the endoscope.
  • Endoscopic mucosal resection (EMR) removes the abnormal portion of the lining through an endoscope, after confirming the cancer hasn't moved deeper into the esophagus walls.
  • Surgery to remove most of the esophagus is an option in cases where severe precancer or cancer is diagnosed. The earlier the surgery is done, the better the chance for the cure.

If you have concerns about Barrett’s esophagus, request an appointment at San Bernardino Gastroenterology Associates.