Barrett’s esophagus is a change in your cells lining your esophagus (food tube). It’s more common in people with acid reflux (GERD), but can develop without having GERD. Management ranges from monitoring your esophageal lining with endoscopies to treatments to remove damaged tissue. Keep your esophagus healthy by managing heartburn or acid reflux.
Barrett’s esophagus is a change in the tissue lining your esophagus, the tube in your throat that carries food to your stomach. For reasons no one understands completely, cells in the esophageal lining sometimes become more like intestinal cells.
Researchers suspect that having acid reflux or gastroesophageal reflux disease (GERD) is related to Barrett’s esophagus. Barrett’s esophagus raises the risk of developing a rare esophageal cancer.
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People who are more likely to develop Barrett’s esophagus:
They may also have:
On its own, Barrett’s esophagus doesn’t produce symptoms. You may discover you have it only after seeing your healthcare provider for gastroesophageal reflux disease (GERD) symptoms or after developing esophageal cancer. Because of the lack of symptoms, no one is sure how common it is. But experts estimate that Barrett’s esophagus affects about 1% of people.
Multiple factors contribute to Barrett’s esophagus. It’s more common in people with GERD. This chronic (ongoing) condition occurs when stomach contents flow backward into the esophagus. Experts believe the acidic liquid irritates the lining of the esophagus, leading to changes in the tissue. But you can also have Barrett’s esophagus without having GERD.
Barrett’s esophagus does not cause symptoms. But you can watch for signs of the conditions it’s associated with — heartburn and acid regurgitation.
Heartburn that occurs at least twice a week is the biggest red flag. Heartburn symptoms include a burning sensation in the chest and vomit in the back of the throat (acid regurgitation).
Other symptoms to watch for include:
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.
Your treatment depends largely on presence of symptoms and dysplasia on biopsies:
Barrett’s esophagus without dysplasia
Having Barrett’s esophagus without dysplasia means your provider didn’t detect precancerous cells. Usually, you don’t need treatment at this stage. But your healthcare provider will want to monitor the condition. You’ll need to have an upper endoscopy every two to three years.
If you have GERD, your healthcare provider may prescribe medications to treat GERD. These medicines decrease stomach acid, which can protect your esophagus from damage. Lifestyle changes, like sleeping slightly inclined and avoiding eating dinner late, often help, too.
Barrett’s esophagus with dysplasia
Dysplasia is the presence of precancerous cells. Your doctor may recommend frequent monitoring or treatment to prevent cancer from developing.
Low-grade dysplasia means you have some abnormal cells, but the majority aren’t affected. In this case, you may just need frequent checks to see if more changes occur. Expect to undergo an upper endoscopy every six months to a year. Ablation therapy is also recommended in select patients.
High-grade dysplasia indicates a substantial change in your esophagus lining. With this diagnosis, cancer is more likely. You may need to repeat upper endoscopies more often to look for cancer. Your provider may also recommend treatment, which focuses on removing the damaged tissue and includes:
The best way to keep the lining of your esophagus healthy is to address heartburn or GERD symptoms. People with ongoing, untreated heartburn are much more likely to develop Barrett’s esophagus. Untreated heartburn raises the risk of esophageal adenocarcinoma by 64 times.
Other ways to decrease your risk factors include:
Barrett’s esophagus is a precancerous condition that may lead to esophageal adenocarcinoma. This type of cancer is rare.
Most people with Barrett’s esophagus don’t have to worry — over 90% won’t develop esophageal adenocarcinoma. However, it’s important to monitor the condition. That way, your healthcare provider can detect any signs of cancer at an early stage.
There isn’t a specific diet for Barrett’s esophagus. If you have GERD or heartburn, consider making the following changes:
A note from Cleveland Clinic
Being diagnosed with Barrett’s esophagus isn’t cause for alarm. But it is good information to have. Consider the diagnosis extra motivation to get manage your GERD symptoms. Also, keep your regularly scheduled endoscopy tests. These two things will ensure that you’re doing everything you can to stay well.
Last reviewed by a Cleveland Clinic medical professional on 06/23/2020.
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