1. What is Barrett's esophagus?
Barrett's esophagus is a condition in which the cells of the lower esophagus begin to change due to the longstanding effects of gastroesophageal reflux disease or GERD. These changes, occurring over time, cause the cells in the lining of the lower esophagus to look more like cells in the intestine. This is called intestinal metaplasia. The ability of the cells to change is thought to be a protective measure against the irritating stomach acid that is flowing back up into the esophagus. However, a change in cellular structure also is a precancerous condition and is watched carefully with endoscopic surveillance and biopsy.
2. What are the symptoms of Barrett's esophagus?
Barrett's esophagus itself has no symptoms and some individuals with GERD may be unaware that they have Barrett's esophagus. Symptoms of gastroesophageal reflux disease (GERD) include heartburn, a sour taste in the mouth from regurgitated stomach contents and acid, and a burning sensation at the back of the throat.
3. Who is at risk of developing Barrett's esophagus?
Individuals with longstanding gastroesophageal reflux disease (GERD) that irritates and inflames the esophageal lining are most at risk of developing Barrett's esophagus. Patients with hiatal hernia, are also at a slightly higher risk than the general population.
Barrett's esophagus is an uncommon occurrence that affects almost twice as many adult men as women. It is also more prevalent among white men than among people in other racial groups. It is estimated that about 5 percent of individuals who have gastroesophageal reflux disease (GERD) will go on to develop Barrett's esophagus.
4. How is Barrett's esophagus diagnosed?
Barrett's esophagus is diagnosed using an endoscope - a thin flexible tube containing miniaturized instruments, including a camera - and a tissue sample. After receiving a mild sedative, a gastroenterologist gently guides the endoscope down the esophagus and takes images that are then transferred to a video monitor. The physician also will take a tissue sample to be examined by pathology. This procedure is called upper gastrointestinal endoscopy (upper GI) with biopsy or esophagogastroduodenoscopy (EGD) with biopsy.
Barrett's esophagus is monitored with regular endoscopic surveillance and biopsy because a change in cells in the esophageal lining is considered a precancerous condition.
5. How is Barrett's esophagus treated?
Barrett's esophagus is monitored regularly with endoscopic surveillance and biopsy to determine if additional changes have occurred within the Barrett's segment. If the biopsy shows low-grade or high-grade dysplasia (more precancerous changes in cells), your gastroenterologist will recommend a procedure to remove the diseased tissue.
6. Is the presence of Barrett's esophagus a precancerous condition?
Yes. Barrett's esophagus, in which cells in the esophageal lining begin to look more like the cells within the intestine or stomach, is a precancerous condition. Cells within Barrett's also can change (dysplasia) further into low- or high-grade precancerous cells. This is the reason why patients who have Barrett's esophagus are monitored regularly with endoscopic surveillance and biopsy.
7. Is my risk of developing cancer higher if I have Barrett's esophagus?
Yes. Patients with Barrett's esophagus are at a significantly higher risk than the general population of developing esophageal cancer.
8. I have Barrett's esophagus and been diagnosed with low-grade dysplasia. Is this cancer?
Low-grade dysplasia within Barrett's esophagus is a precancerous condition and is monitored with more frequent endoscopic surveillance. The reason for increased surveillance is that low-grade dysplasia can turn into high-grade dysplasia and then into esophageal cancer. Your gastroenterologist will discuss surveillance measures and treatment options for low-grade and high-grade dysplasia.