Understanding Barrett’s Esophagus: A Comprehensive Guide

Apr 24, 2024 | Primary Care

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Barrett’s esophagus is a condition that affects the lining of the esophagus, the tube that connects the throat to the stomach, and may cause difficulty swallowing, chronic cough and other issues. While it may sound intimidating, understanding this condition is crucial for those who may be at risk. 

What is Barrett’s Esophagus?

Barrett’s esophagus is a precancerous change that occurs when the cells in the lining of the esophagus change due to repeated exposure to stomach acid. Normally, the esophagus is lined with squamous cells, but in Barrett’s esophagus, these cells are replaced by glandular cells resembling those found in the intestines. This change is known as intestinal metaplasia and is considered a precancerous condition.

What Are the Causes?

The primary cause of Barrett’s esophagus is gastroesophageal reflux disease (GERD), a condition characterized by frequent acid reflux. When stomach acid repeatedly flows back into the esophagus, it can damage the lining over time, leading to the development of Barrett’s esophagus.

Other factors that may increase the risk of developing Barrett’s esophagus include:

  • Chronic heartburn or acid reflux
  • Obesity
  • Smoking
  • Hiatal hernia
  • Age (more common in individuals over 50)
  • Family history of Barrett’s esophagus or esophageal cancer

What Are the Symptoms?

Barrett’s esophagus often does not cause noticeable symptoms. However, some individuals may experience symptoms such as:

  • Frequent heartburn
  • Difficulty swallowing
  • Chest pain
  • Chronic cough
  • Hoarseness
  • Regurgitation of food or sour liquid

It’s essential to consult a healthcare professional if you experience persistent symptoms, especially if you have risk factors for Barrett’s esophagus.

How is It Diagnosed?

Barrett’s esophagus is typically diagnosed through an upper endoscopy, also known as an esophagogastroduodenoscopy (EGD). During this procedure, a flexible tube with a camera at the end (endoscope) is inserted through the mouth and into the esophagus to examine the lining for any abnormalities. Biopsies may be taken during the procedure to confirm the presence of Barrett’s esophagus and assess the severity of changes. 

Follow up is required for this condition to identify any early changes or dysplasia in Barrett’s esophagus that may be concerning for malignancy or becoming a malignancy. Surveillance and an EGD follow-up can be required anywhere from 6 months to 5 years.  

What Are the Treatment Options?

  • Lifestyle modifications: This includes avoiding triggers such as spicy and fried foods, peppermint, caffeine, alcohol and smoking. Elevating the head of the bed while sleeping and maintaining a healthy weight can also help alleviate symptoms.
  • Medications: Proton pump inhibitors (PPIs) and H2-receptor antagonists are commonly prescribed to reduce acid production and alleviate symptoms of GERD.
  • Endoscopic therapy: In cases where precancerous changes are detected, endoscopic techniques such as radiofrequency ablation or endoscopic mucosal resection may be used to destroy those cells. 
  • Surgery: A procedure called fundoplication may be an option for some patients. This surgery is not performed for Barrett’s esophagus. But, if GERD symptoms are not managed by medication, it may be a possibility. 

While Barrett’s esophagus may sound daunting, early detection is the best protection. If you experience symptoms of acid reflux or have risk factors for Barrett’s esophagus, talk with your primary care provider who can connect you to appropriate screenings. 

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