What is Barrett’s Esophagus?
What is Barrett’s Esophagus?Barrett's esophagus, also known as Barrett’s syndrome or Barrett’s disorder, is a condition that develops after the lining of the esophagus (the swallowing tube that connects the mouth to the stomach) becomes damaged by acid reflux. The damage to the lining causes it to become red and thick. The cells in the esophageal lining can also begin to resemble intestinal cells, though the reason behind this change is unknown. The development of Barrett's esophagus is often attributed to patients' long-lasting cases of GERD (gastroesophageal reflux disease).
While Barrett’s esophagus is more common in people with acid reflux (GERD), it can also develop in patients with no history of GERD symptoms. The esophageal disorder is not very common, only affecting about 1% of the population, but is present in 5-10% of people with long-standing GERD symptoms and is more prevalent in those with a family history of esophageal cancer.
Stages of Barrett’s Esophagus
StagesDoctors use a technique called endoscopy to diagnose and stage Barrett’s esophagus in patients. Our gastroenterologists at NewYork-Presbyterian are at the forefront of esophageal treatment, only using the latest and least invasive instruments to find the right diagnosis and treatment plan for you.
Barrett’s esophagus has five diagnosed stages:
- Non-dysplastic (no cancerous tissue present). You don’t need treatment at this stage but will most likely receive medication to reduce stomach acid production and undergo an upper endoscopy every 3-5 years to monitor symptoms.
- Low-grade dysplasia (minor cell changes found). In this stage, minor abnormalities in the cells were detected. To monitor any further changes, you will most likely undergo an upper endoscopy every six months to a year and in certain cases, ablation therapy may be recommended.
- High-grade dysplasia (extensive cell changes found, but not yet cancer). This stage is more serious and indicates a substantial change in your esophagus lining. Cancer is more likely due to the extensive cell changes, so you will need to undergo upper endoscopies frequently. There are several treatments available that focus on removing or ablating the damaged tissue such as endoscopic mucosal resection, radiofrequency ablation, and cryoablation.
- Invasive cancer. Most esophageal cancers can be classified into one of two types: adenocarcinoma or squamous cell carcinoma. Small cell carcinoma can also develop but is extremely rare. If detected at a very early stage, cancer can be removed with an endoscopy. You may undergo surgery to limit or prohibit the spreading of cancer cells from the esophagus to the rest of the body.
Signs & Symptoms of Barrett’s Esophagus
SymptomsBarrett’s esophagus affects everyone differently, but many patients with Barrett’s esophagus have no symptoms at all. The abnormal tissue changes that occur are not typically felt but need to be confirmed through diagnostic testing. One of the most telling symptoms can be heartburn which occurs at least twice a week. Heartburn is a burning sensation in the chest and the presence of vomit in the back of the throat.
If you have Barrett's esophagus, you may experience symptoms commonly associated with chronic GERD. Symptoms you may experience:
- Heartburn (especially worsening or intense episodes)
- Regurgitation of food
- Chest pain
- Painful or difficulty swallowing
- Sensation of food stuck in your esophagus
- Constant sore throat or sour taste in your mouth
- Unintentional weight loss
- Blood in stool
What Causes Barrett’s Esophagus?
CausesThere is no definitive cause of Barrett's esophagus.
Although GERD is highly linked to the development of Barrett’s esophagus or Barrett’s syndrome, some patients have no prior history of symptoms of acid reflux.
Risk Factors
Risk FactorsRoughly 30 million people in North America have GERD, but only 5 percent of patients with chronic GERD will develop Barrett's esophagus. While the risk factors associated with this disorder are still being researched, Barrett’s esophagus is more common in certain groups of the population:
- Individuals diagnosed with gastroesophageal reflux disease (GERD)
- Caucasians
- Those assigned male at birth
- Advanced age
- Overweight or obese individuals
- Smokers
- Those with a family history of Barrett’s esophagus or esophageal cancer
Complications
ComplicationsAt NewYork-Presbyterian, our gastroenterologists and specialists will create individualized treatment plans for you. While the symptoms can be treated, the disease can change and become more severe over time.
Some complications associated with Barrett’s esophagus are:
- Esophageal cancer
- This complication is rare, over 95% of those diagnosed with Barrett’s esophagus won’t develop esophageal adenocarcinoma. However, the normal cells in the esophageal lining can change over time and it’s important to monitor the condition to ensure there are minimal to no cancerous cells found during biopsies and endoscopies.
Prevention
PreventionAs Barrett’s esophagus can appear in patients with no history of acid reflux, doctors recommend screening patients with chronic GERD. Other preventative measures to hinder the development of Barrett’s esophagus are:
- Quitting smoking. Smoking irritates can damage the esophageal tissue, causing the cells to protect themselves by changing their properties.
- Maintaining a healthy weight. Having extra fat around the abdomen squeezes your stomach, causing more fluid to travel upward into your esophagus. This makes it more likely you will experience stomach acid leakage and GERD, causing damage to the esophageal lining.
- Taking a proton pump inhibitor. This is recommended for all Barrett’s patients, regardless of symptoms. Data supports that PPIs lower the risk of eAC in Barrett’s patients.
Best Diet for Barrett’s Esophagus
While there aren’t any food or lifestyle changes directly linked to the prevention of Barrett’s esophagus, there are dietary changes that can be made to alleviate a majority of symptoms of acid reflux.
The dietary changes that can be implemented are:
- Diets high in fruits and vegetables and fiber, and low in red meat
- Decreasing the amount of butter, oils, chocolate, tomato sauce, salad dressings, gravy, fatty meats, and full-fat dairy products you intake
- Eating small meals a few times a day instead of large amounts of food at one time
- Eating three hours before going to bed
- Avoiding carbonated beverages
- Avoiding fried foods
- Maintaining a balanced diet with fruits, vegetables, beans, lentils, and herbs
- When eating grains, choose oats, whole grain bread, brown rice, and quinoa as opposed to glucose, white bread, or white rice
- Avoiding sugary foods like ice cream and other desserts
- Keeping track of when you experience heartburn to identify trigger foods
Trust NewYork-Presbyterian for Barrett’s Esophagus Care
At NewYork-Presbyterian, we have an array of advanced techniques to diagnose and treat Barrett’s esophagus and detect precancerous cells and their changes from abnormal cells or early cancer, including methods not routinely available elsewhere. Weill Cornell Medicine and Columbia University investigators are also involved in numerous clinical trials studying novel treatments for Barrett’s esophagus and esophageal precancer, and we are pleased to offer participation in these studies to our patients who qualify.
Make an appointment with us today to find out how we can help you.