Is Barrett's Esophagus Serious?

Barrett's esophagus is a condition in which the esophagus is damaged due to acid reflux. It is a serious condition that may progress to cancer of the esophagus.

Barrett’s esophagus is a serious medical condition in which the inner lining of the food pipe (esophagus) is damaged due to acid reflux. The food you eat passes from the mouth and throat to the stomach via a tube-like structure called the esophagus. The junction where the lower end of the esophagus meets the stomach is called the gastroesophageal junction (GEJ). The type of cells lining the esophagus and stomach are different. A muscular valve called the lower esophageal sphincter (LES) guards the backflow of the acidic stomach contents into the food pipe. In gastroesophageal reflux disease (GERD), the LES does not close properly allowing the stomach contents to leak back or reflux into the food pipe and irritate it. The reflux of stomach contents into the esophagus may also happen in other conditions, such as severe obesity, stress and hiatal hernia (a condition in which the stomach bulges up into the chest through an opening in the diaphragm). The diaphragm is the muscle that separates the two areas. Prolonged irritation of the lining of the esophagus causes a change in the structure of its cells making it resemble the lining of the stomach. This condition is called Barrett's esophagus. It can progress to cancer in the affected area. A person diagnosed with this condition must go for regular checkups to the doctor to rule out the development of cancer.

Barrett's esophagus is more common in men than in women. People with chronic and untreated GERD have a high risk of Barrett's esophagus. People with a family history of Barrett's esophagus may have a higher risk of developing this condition.

Barrett's esophagus as such does not cause any symptoms. The associated conditions causing Barrett's esophagus may lead to the following symptoms

• Heartburn (a sensation of burning and discomfort in the chest). When heartburn occurs at least twice a week the chances of having Barrett's esophagus are high.
• Acid regurgitation (reflux of acidic contents into the throat), which makes the mouth taste sour
• Difficulty or pain while swallowing
• Feeling that food gets stuck in the food pipe
• Chest pain or discomfort
• Recurrent or continuous sore throat
• Vomiting

The symptoms must not be ignored and early medical help must be sought. If you develop symptoms such as unintended loss of weight, difficulty swallowing, and severe heartburn that wakes you from sleep, you must contact your doctor immediately.

The treatment for Barrett's esophagus focuses mainly on treating the underlying conditions that cause GERD and regular screening for the development of cancer. The treatment may include

• Lifestyle and home remedies
  • Eat small meals.
  • Eat your food slowly.
  • Avoid certain foods and beverages such as spicy and oily foods, citrus, tomato, mint, garlic, chocolate, tea, coffee, carbonated drinks and alcohol.
  • Do not lie down right after eating.
  • Do not snack close to bedtime.
  • Maintain a healthy weight.
  • Do not smoke.
• Medications
  • Take antacids to neutralize stomach acid.
  • Take H2 blockers to decrease acid production.
  • Use foaming agents to coat the stomach to prevent reflux.
  • Proton pump inhibitors reduce the amount of acid the stomach makes.
  • Prokinetics help strengthen the lower esophageal sphincter (LES), empty the stomach faster and reduce acid reflux.
• Surgery: If medications do not provide lasting relief and symptoms are severe enough to interfere with everyday activities, the doctor may recommend surgical options including
  • LINX device placement: The procedure involves surgically placing a ring (LINX device) around the outside of the lower end of the esophagus.
  • Fundoplication: The procedure creates an artificial valve using the upper part of the stomach.

The management of Barrett's esophagus also depends on the presence of any abnormal tissue. This is investigated through endoscopic biopsy. If biopsy results show cell changes that may be cancer, the doctor may advise surgery or other procedures to treat it. Some of the procedures for removing harmful tissue from the esophagus include

• Photodynamic therapy (PDT): This uses a special laser device to remove the abnormal tissue.
• Cryotherapy: This uses a cold liquid or gas to remove the abnormal lesion.
• Radiofrequency ablation: This uses heat to remove the abnormal tissue.
• Surgical resection of the abnormal tissue.