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Barrett's Esophagus Could Be Dangerous, So Watch for These Signs

If you have acid reflux, or GERD, you know it can be annoying or irritating. The sensation of heartburn may make you avoid large meals or certain foods, sleep with the head of your bed raised, and take medication regularly. But you might not realize that GERD is also linked with a health condition called Barrett’s esophagus.

As the name suggests, Barrett’s esophagus affects your esophagus—the tube that carries food and fluids from your mouth to your stomach. Often, but not always, it develops in people who have acid reflux, or GERD, for a long period of time. Emil Graf, MD, a general and bariatric surgeon with Banner Health in Arizona, explained more about the condition, why it can be concerning, and how it can be treated.

What is Barrett’s esophagus?

“Different parts of our intestines have different linings. That’s what allows them to perform specialized functions,” Dr. Graf explained. Barrett’s esophagus develops at the junction where your esophagus meets your stomach. Normally, your esophagus is lined with tissue that is similar to your skin. But with this condition, this tissue becomes more like the lining of the intestine.

What causes Barrett’s esophagus?

Put simply, your stomach acid is the culprit. Stomach acid can sometimes enter the lower part of the esophagus. Over time that acid damages your esophagus and inflammation starts to develop. This inflammation causes the lining of the esophagus to change and become more like the intestinal lining.

What increases your risk of Barrett’s esophagus?

Some of the risk factors are out of your control. Your risk is higher if you:

  • Have a close family member who had Barrett’s esophagus or esophageal cancer
  • Are a white, non-Hispanic male
  • Have a long history of gastroesophageal reflux disease (GERD)

But other risk factors are within your control. You’re at higher risk if you’re obese or you smoke, so taking steps to reduce your weight and quitting smoking can help lower your risk.

What are the symptoms of Barrett’s esophagus?

Oftentimes, you won’t have symptoms and it might be diagnosed when you have an upper endoscopy scan performed for another reason. Any symptoms that you do notice are actually symptoms of GERD, not Barrett’s esophagus:

  • Indigestion
  • Heartburn
  • Acid regurgitation, especially at night when lying flat
  • Chronic hoarseness or throat clearing

Dr. Graf points out that not all people with GERD have Barrett’s esophagus, and Barrett’s esophagus doesn’t cause the symptoms of GERD. But chronic GERD increases your risk of Barrett’s esophagus.

How is Barrett’s esophagus diagnosed?

For diagnosis, doctors perform an upper endoscopy, which is a test that passes a small, flexible camera into the mouth and esophagus. With the camera, doctors can see the lining of the esophagus and the stomach. They can also take biopsies of the lining of the esophagus. A pathologist can examine these samples under a microscope to see if they show signs of the condition.

There aren’t any screening recommendations for Barrett’s esophagus. If you have a history of GERD, talk to your doctor when you schedule your screening colonoscopy. It might be possible to schedule an upper endoscopy at the same time to look for signs of Barrett’s esophagus, Dr. Graf said. Even if you only had GERD symptoms briefly, or you take medication and feel it’s well-controlled, you should consider having an upper endoscopy with your colonoscopy. It’s especially important if you use tobacco products or are obese.

How is Barrett’s esophagus treated?

Medications and surgery can help treat chronic GERD, but they do not cure Barrett’s esophagus. It’s treated once it progresses to a more dangerous form. At that point, these options can treat the precancerous cells:

  • Radiofrequency ablation, which uses heat to destroy them
  • Cryotherapy, which uses cold, typically liquid nitrogen
  • Photodynamic therapy, which uses an injected drug that’s activated by a laser 

“Since these treatments have potential risks, they aren’t the first line of therapy for early Barrett’s esophagus,” Dr. Graf said.

What is the connection between Barrett’s esophagus and esophageal cancer?

The changes in the lining of the esophagus that occur can lead to cancer. Your doctor can watch for signs that your cells are changing over time. Each year, about one in 200 people with Barrett’s esophagus are diagnosed with esophageal cancer. If you have the condition, you have a 5 to 10% chance of developing esophageal cancer in your lifetime.

The bottom line

Barrett’s esophagus is a health condition that often develops if you have acid reflux for a long time. Quitting smoking and losing weight if needed can help reduce your risk. If you would like to connect with a health care provider to discuss your likelihood of developing Barrett’s esophagus or other gastrointestinal conditions, reach out to Banner Health.

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