What is Barrett’s esophagus and how is it treated?
Barrett's esophagus is an irritation in the lining of the
esophagus caused by chronic reflux of the contents from the stomach and small
intestine into the esophagus. There are a number of risk factors for the
development of Barrett's esophagus, including:
- Symptoms of gastroesophageal reflux disease (GERD)
- Obesity
- Increasing age
- Being Caucasian
- Being male
- Family history
The symptoms of Barrett's esophagus are similar to the symptoms
of GERD. These include a burning sensation under the chest and acid
regurgitation. These symptoms generally decrease with medications that reduce
acid in the stomach.
Some people with Barrett’s may also have difficulty swallowing.
This symptom requires immediate medical attention.
The only way to confirm the diagnosis of Barrett's esophagus is
with a test called an upper endoscopy. This involves inserting a small lighted
tube (endoscope) through the throat and into the esophagus to look for a change
in the lining of the esophagus.
While the appearance of the esophagus may suggest Barrett's
esophagus, the diagnosis can only be confirmed with small samples of tissue
(biopsies) obtained through the endoscope. A pathologist will examine the tissue
to make the diagnosis.
The treatment of Barrett's esophagus is similar to the treatment
of GERD. This includes lifestyle changes, such as avoiding certain foods, not
eating late in the evening, and stopping smoking, along with using medications
that will decrease acid production by the stomach.
Patients with Barrett's esophagus typically need prescription
medications to reduce acid, such as omeprazole (Prilosec®),
lansoprazole (Prevacid®), pantoprafile (Protonix®),
rabeprazole (Aciphex®), esomeprazole (Nexium®) and
dexlansoprazole (Kapidex®). These medications are typically taken
before breakfast once a day or, on occasion, before breakfast and dinner.
Over-the-counter medications known as H2 receptor antagonists (Tagamet®,
Zantac®, Axid®, and Pepcid®) are generally not
as effective in decreasing the acid damage to the esophagus that causes
Barrett's esophagus, but may relieve symptoms for some patients. H2 receptor
antagonists are also available as prescription medications.
Barrett's esophagus is a premalignant condition that may lead to
the development of cancer of the esophagus in some patients. The risk of
developing cancer is approximately 0.5% each year.
Esophageal cancer develops through a sequence of changes in the
cells of the esophagus known as dysplasia. Dysplasia can only be detected by
endoscopic biopsies. Patients with Barrett's esophagus should have regular
surveillance exams to detect cancer at an early and potentially curable stage.
Studies are in progress to develop a more effective treatment
for Barrett's esophagus. One treatment, known as ablation therapy, damages the
lining of the esophagus with heat or laser light. This causes normal cells to
develop because of a decrease in acid production. This type of therapy holds
great promise for the future, although it is still in the testing phase. Other
new treatments are also under development.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on:8/25/2009…#9621
