Barrett's Esophagus

Understanding Barrett's Esophagus: A Guide to this Esophageal Condition

Barrett's esophagus is a condition that affects the lining of the esophagus, the tube that carries food from your mouth to your stomach. It is considered a complication of chronic acid reflux, also known as gastroesophageal reflux disease (GERD). While it may not cause symptoms itself, Barrett's esophagus is significant because it increases the risk of developing esophageal adenocarcinoma, a type of esophageal cancer.

What Is Barrett's Esophagus?

In healthy individuals, the lining of the esophagus is made up of stratified squamous cells. However, in Barrett's esophagus, this normal lining is replaced by abnormal columnar cells, similar to the lining of the stomach or intestines. This process, called intestinal metaplasia, occurs as a response to prolonged exposure to stomach acid.

Causes and Risk Factors

The primary cause of Barrett's esophagus is longstanding GERD. Factors that increase the risk include:

• Chronic acid reflux symptoms
• Obesity
• Smoking
• Family history of esophageal cancer
• Age over 50
• Male gender (men are more commonly affected)

Symptoms

Interestingly, Barrett's esophagus itself often does not cause specific symptoms. People usually become aware of underlying GERD symptoms, such as:

• Heartburn
• Regurgitation
• Difficulty swallowing
• Chest pain

Regular monitoring is essential because changes in the esophageal lining can be detected even before symptoms develop.

Diagnosis

Diagnosis involves an upper endoscopy, during which a doctor visualizes the esophagus with a thin, flexible tube equipped with a camera. A biopsy — a small tissue sample — is typically taken to analyze the cells under a microscope, confirming the presence of abnormal cells characteristic of Barrett's esophagus.

Treatment Options

While there is no cure for Barrett's esophagus, treatment aims to:

• Manage acid reflux symptoms (e.g., with proton pump inhibitors or PPIs)
• Prevent progression to cancer through regular surveillance
• Remove or destroy abnormal cells if dysplasia (pre-cancerous changes) is detected