Barrett's Esophagus (cont.)
Bhupinder Anand, MD
Wilfred M. Weinstein, MD
In this Article
What is Barrett's esophagus?
Comment on this Read 26 Comments
Barrett's esophagus is a complication of chronic gastroesophageal reflux disease (GERD), primarily in white men. GERD is a disease in which there is reflux of acidic fluid from the stomach into the esophagus (the swallowing tube). GERD most commonly causes heartburn.
There are two requirements for the diagnosis of Barrett's esophagus. The requirements necessitate an endoscopy of the esophagus. During endoscopy, a long flexible tube with a light and camera at its tip (an endoscope) is inserted through the mouth and down into the esophagus to view and biopsy (sample tissue from) the lining of the esophagus. The two requirements are:
Barrett's esophagus is officially coded by the Library of Congress for electronic searches of the literature as Barrett esophagus, but Barrett's esophagus (with the apostrophe "s") is the name used universally. The condition is named after a surgeon, Norman Barrett, who described the condition. However, it turns out that his interpretation of the findings was not correct. In 1953, Doctors' Allison and Johnstone actually described this condition as we now understand it, namely that metaplasia was occurring. (Metaplasia, which is discussed below, is the term used when one adult tissue replaces another.) Nevertheless, the condition has been immortalized with Barrett's name.
Initially, it was thought that the Barrett's esophagus consisted of stomach (gastric) tissue replacing the usual squamous tissue lining the esophagus. However, in the mid 70's, Dr. Paull and colleagues published a paper in which they described the mucosa (inner lining) of Barrett's esophagus in greater detail than had been done previously. They pointed out that Barrett's esophagus consisted of a metaplasia in which the normal cells lining the esophagus were replaced by a mixture of gastric and intestinal lining cells. The intestinal-type lining cells also are called specialized columnar cells which include goblet cells. For a number of years, some scientists thought that there were two types of Barrett's; one in which the normal lining was replaced with stomach (gastric) type cells only, and the second in which intestinal cells were present. However, the current belief is that only the presence of intestinal-type goblet cells establishes the diagnosis of Barrett's esophagus, regardless of what other cell types are present.
Medically Reviewed by a Doctor on 12/10/2013
Viewers share their comments