Barrett’s esophagus is a condition in which the tissue that lines your esophagus (the tube that connects your mouth to your stomach) is replaced by tissue that is like the lining of the intestines. Both the color and the composition of the tissue changes when this happens.
No signs or symptoms are associated with Barrett’s esophagus, but the condition is commonly found in people who suffer from GERD. Barrett’s esophagus affects about one percent of American adults. Men developing the condition twice as often as women, and Caucasian men more affected than men of other races. According to the National Institutes of Health (NIH), the average age at diagnosis is 50.
The exact causes of Barrett’s esophagus remain unknown. However, GERD is an identified risk factor for the condition. Although some people who have Barrett’s esophagus don’t have GERD, the pre-cancerous condition is three to five times more likely to occur in GERD patients.
Acid reflux and the damage it causes to the lining of the esophagus is one way that Barrett’s esophagus is believed to develop. When you swallow food, it travels from your throat to your stomach and through your esophagus. Under normal circumstances, muscles in the lower esophagus keep food in your stomach. However, stomach acid can move back into your esophagus through reflux action if these muscles malfunction. This can lead to the lining damage that’s characteristic of Barrett’s esophagus if left untreated.
The Mayo Clinic states that the risk of developing cancer from Barrett’s esophagus is low. But, the condition is associated with an increased risk of developing a rare, though frequently life-threatening type of throat cancer called “esophageal adenocarcinoma.” According to the NIH, less than one percent of people diagnosed with Barrett’s esophagus develop this type of cancer annually.
The pre-cancerous condition can be present for several years before cancer develops. Therefore, esophageal adenocarcinoma often remains undetected until later stages, when treatments may be less effective. Your doctor will likely recommend a method of looking for early warning signs of cancer called “surveillance” if you’re diagnosed with Barrett’s esophagus.
Surveillance involves regularly scheduled biopsies and examinations to check for a condition called dysplasia. Typically, pre-cancerous cells that are detectable through biopsies appear in the tissue before esophageal cancer develops. Detecting and treating this dysplasia may help prevent cancer from developing.
There are several possible treatment options for Barrett’s esophagus that primarily fall into two categories: endoscopic treatments and surgical treatments.
These types of treatments involve passing an endoscope (a long, flexible tube) down the throat into the esophagus. According to the American Cancer Society (ACS), the goal of these procedures is to destroy the Barrett’s lining. The damaged part of the lining will be cut out if the condition has progressed to dysplasia or cancer.
The following are some endoscopic treatments that your doctor may recommend:
- Photodynamic therapy: uses a light-sensitizing compound called Photofrin and a laser to destroy pre-cancerous and cancerous cells.
- Endoscopic mucosal resection: involves lifting the Barrett’s lining and injecting a solution under it or applying suction and cutting it out to remove it.
Surgical interventions generally involve removing most of the esophagus and abnormal lining, pulling a portion of the stomach into the chest, and attaching it to the remaining esophagus. The NIH recommends this treatment only for those diagnosed with Barrett’s esophagus who also have severe dysplasia or cancer and can tolerate surgery. For most people, less-invasive treatments (such as endoscopy) are preferred. However, surgery that occurs soon after diagnosis may offer the best chance of a cure for severe cases.
Diagnosis and treatment of GERD symptoms such as acid reflux may help to prevent Barrett’s esophagus or prevent the condition from progressing. However, the National Center for Biotechnology Information (NCBI) suggests that no treatment will reverse the changes that may lead to cancer. Therefore, calling your doctor if you have worsening GERD symptoms—particularly if you’ve already been diagnosed with Barrett’s esophagus—is your best chance to prevent cancer from developing.
Written by: Robin Madell
Medically reviewed by George Krucik, MD