Barrett’s Esophagus | Digestive Health Program | Loyola Medicine

Barrett’s Esophagus

Overview and Facts about Barrett’s Esophagus

Barrett’s esophagus is a condition affecting the esophagus, which is the tube that connects your mouth to your stomach. In Barrett’s esophagus, cells that form the tissue lining the esophagus are damaged by gastroesophageal reflux disease. These damaged cells are then replaced by different, abnormal cells. While the tissue change does not cause symptoms or influence your digestive health, patients with Barrett’s esophagus have an increased risk of developing esophageal cancer and should monitor their condition closely.

Signs and Symptoms of Barrett’s Esophagus

Many people who have Barrett’s disease do not show any signs or symptoms of the disease; however, symptoms associated with gastroesophageal reflux may be experienced. These include frequent heartburn from acid reflux, difficulty swallowing and chest pain.

Causes and Risk Factors of Barrett’s Esophagus

While the actual cause of the condition is unknown, people who suffer from chronic gastroesophageal reflux are at risk for developing Barrett’s esophagus. In a complication of the disease, the acidic contents of the stomach get pushed back into the esophagus, causing damage to the tissue lining the throat. In the body’s attempt to heal the damaged tissue, different cells grow back replacing the original esophageal cells.

Barrett’s esophagus mostly affects older, white males. Additional risk factors include a history of smoking, being overweight and having chronic heartburn or acid reflux.

Tests and Diagnosis of Barrett’s Esophagus

To diagnose Barrett’s esophagus, a doctor will perform an endoscopy procedure in which a small camera attached to the end of a tube is passed down the esophagus. The endoscopy allows the doctor to check for signs of Barrett’s esophagus, namely changes in tissue appearance, which will look red rather than pale and glossy. A biopsy, or small tissue sample, may be taken during the procedure for further examination under a microscope. A biopsy is used to determine if precancerous or cancerous cells are present.

Treatment and Care for Barrett’s Esophagus

Treatment of Barrett’s esophagus depends on the disease prognosis and whether or not cancerous cells have been detected. Patients that have abnormal cells with no signs of cancer are recommended to have periodic routine endoscopies performed to monitor their Barrett’s esophagus and continue treatment for symptoms of gastroesophageal reflux disease.

Other treatment options include medication and surgery.

Medication

Your Loyola doctor may prescribe medications to help you reduce stomach acid. This may be done in conjunction with lifestyle changes to control GERD or as a secondary treatment. You also may be prescribed medication to heal any sores in your esophagus.

Medication to reduce stomach acid is a common treatment if you have Barrett's esophagus. Medications do not cure the disease, but help keep it in check. Barrett's esophagus with high grade dysplasia is considered highly precancerous and requires additional treatment beyond medication.

Surgery

If your Barrett's esophagus is severe or is not controlled by medication, your doctor may recommend surgery. Your surgeon will review your case and make an individualized recommendation for the most appropriate procedure. Procedures performed by Loyola’s expert surgeons to treat Barrett's esophagus include:

  • Cryotherapy — A new method that uses liquid nitrogen to freeze the affected area of the esophagus. The diseased tissue eventually sloughs off, and the area covers over with normal epithelium as long as you keep stomach acid suppressed. Loyola is the first in Illinois to use cryotherapy treatment for Barrett's esophagus.
     
  • Endoscopic mucosal resection (EMR) — A procedure that involves removing the diseased part of your esophagus through an endoscope. The procedure, which spares the removal of your esophagus, can be done on an outpatient basis. In most cases, you may return to your normal activities the next day.
     
  • Esophagectomy — A major surgery in which part of the esophagus is removed. The remaining part may be connected directly to the stomach so that you can swallow. This is a significant surgery that will cause permanent lifestyle changes. It is reserved for patients with invasive esophageal cancer and some patients with severe reflux disease.
     
  • Radiofrequency ablation — Involves placing an electrode directly on the diseased tissue in the esophagus. The electrode destroys the disease using heat. Several sessions of ablation may be needed before Barrett's esophagus is completely gone. This is an outpatient procedure. Some patients experience minor chest pain during the first week following the procedure, but this is managed with prescription medication.

Your Loyola gastroenterologist will discuss all options with you, including the risks and benefits of any recommended treatment plan. Surgery may be recommended if endoscopic treatments are not possible, not recommended or may be ineffective for your particular situation. Loyola’s doctors are expert in the treatment of Barrett’s esophagus and will provide the most advanced care with precision and compassion.