Barrett’s esophagus is a condition in which the cells of your lower esophagus become damaged, usually from repeated exposure to stomach acid. The damage causes changes to the color and composition of the esophagus cells.
Barrett’s esophagus is most often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. A small percentage of people with GERD will develop Barrett’s esophagus.
A diagnosis of Barrett’s esophagus can be concerning because it increases the risk of developing esophageal cancer. Although the risk of esophageal cancer is small, monitoring of Barrett’s esophagus focuses on periodic exams to find precancerous esophagus cells. If precancerous cells are discovered, they can be treated to prevent esophageal cancer.
When to see a doctor
If you’ve had long-term trouble with heartburn and acid reflux, you could be at risk for Barrett’s esophagus. There are no specific symptoms that would alert you or your doctor to know if you have Barrett’s esophagus other than those of chronic acid reflux which may include:
- Frequent heartburn
- Sour brash, bad breath, sore throat
- Difficulty swallowing food
- Chest pain
- Upper abdominal pain
- Dry cough
Diagnosing Barrett’s esophagus
We can determine if you have Barrett’s esophagus using a procedure called upper endoscopy. During this examination, you are sedated by an anesthesiologist; there is no pain or discomfort. Biopsies from the lower part of the esophagus are taken during the exam and sent to the pathology lab for analysis. Barrett’s esophagus has a characteristic appearance during endoscopy, the diagnosis is confirmed by the biopsy results.
Determining the degree of tissue changes
Intestinal metaplasia is the term used to describe the transformation of tissue within the esophagus that signifies Barrett’s esophagus. Before becoming cancer, the cells will transform from intestinal metaplasia to various grades of dysplasia (abnormal cell pattern). The pathologist determines the degree of changes (dysplasia) in your cells. Grades of dysplasia include:
- No dysplasia. If no changes are found in the cells, the pathologist determines there is no dysplasia.
- Low-grade dysplasia. Cells with low-grade dysplasia may show small signs of changes.
- High-grade dysplasia. Cells with high-grade dysplasia show many changes. High-grade dysplasia is thought to be the final step before cells change into esophageal cancer.
The type of dysplasia detected in your esophageal tissue determines your treatment options.
The treatment for Barrett’s esophagus is to treat the underlying acid reflux with daily use of antacids, mostly Proton Pump Inhibitors (ie. Nexium, Prilosec, Prevacid, etc). Patients are followed with periodic upper endoscopy to take biopsies so that if dysplasia develops, treatment can be sought to eradicate Barrett’s esophagus or to decrease the time between surveillance endoscopy examinations.
A new device has been FDA-approved for the treatment of Barrett’s esophagus and has been shown in randomized controlled trials to effectively cure Barrett’s esophagus and prevent progression to cancer in high-risk patients. Our practice is offering this new technology called Radiofrequency Ablation. We are using the HALO-360 and HALO-90 catheters to perform ablation of Barrett’s esophagus. We are proud to be one of the few practices in the entire New York/Connecticut area to offer this exciting new non-surgical treatment to eradicate Barrett’s esophagus and prevent esophageal cancer.
To learn more about Barrett’s esophagus, esophageal cancer and ablation of Barrett’s esophagus: http://treatbarretts.com/