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Barrett’s Esophagus

What is Barrett’s esophagus?

Barrett’s esophagus is a change in the lining of your esophagus. The esophagus is the tube that carries food from your throat to your stomach.

If Barrett’s esophagus is not treated, sometimes it can develop into cancer. Cancer of the esophagus may be prevented if Barrett’s esophagus is found and treated early and followed up with regularly scheduled exams.

What is the cause?

Barrett’s esophagus results from stomach fluids that flow backward into your esophagus. When you swallow food and liquids, they flow down the esophagus to the stomach. A ring of muscle around the lower end of the esophagus opens up and lets the food go into your stomach. Normally, the muscle then closes and keeps stomach contents from going back into your esophagus. If the ring of muscle is weak or too relaxed, it doesn’t stay closed and stomach acid and food can flow backwards into your esophagus. This backward movement of stomach fluids is called reflux. The acid can irritate the esophagus and can cause pain. If reflux happens often, you may have gastroesophageal reflux disease (GERD). Constant irritation from GERD can change the lining of the esophagus.

Most people with Barrett's esophagus are white males, over age 50, who have had GERD for many years. However, some people with Barrett's esophagus never have symptoms of GERD, and some people with GERD never develop Barrett's esophagus.

What are the symptoms?

You may have symptoms of reflux. Until it is severe, Barrett’s esophagus does not cause any other symptoms. Symptoms of reflux may include:

  • Heartburn, which is a burning pain or warmth usually felt in the middle to lower part of your chest or breastbone.
  • Bitter or sour taste in your mouth
  • Cramping, severe pain, or pressure below the breastbone
  • Unexplained dry coughing
  • Trouble swallowing or food getting stuck in the esophagus
  • Wheezing, shortness of breath, and chest tightness
  • Hoarse or raspy voice
  • Unexpected weight loss

Barrett's esophagus symptoms may be confused with symptoms of a heart attack. Get emergency care if your heartburn does not get better within 15 minutes after treatment or if you have chest discomfort (pressure, fullness, squeezing or pain) that goes away and comes back, sweating, or chest discomfort that goes to your arms, neck, jaw or back. These symptoms may be signs of a heart attack.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • An ultrasound, which uses sound waves to show pictures of the esophagus
  • Endoscopy, which uses a slim, flexible, lighted tube passed through your mouth to look at your esophagus and stomach. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing.

How is it treated?

The goals of treatment are to control reflux, keep your esophagus lining from getting scarred, and prevent cancer. Your healthcare provider may recommend or prescribe:

  • Lifestyle changes such as quitting smoking, changing your diet, or losing weight. If you drink alcohol, your provider may recommend drinking less or not drinking at all.
  • Medicine to lower the acid in your stomach
  • Regular endoscopic exams to check for cancer

If the lining of your esophagus has a lot of abnormal tissue, the tissue may be removed by:

  • Cutting the abnormal tissue away with tiny tools through an endoscope
  • Destroying the tissue with a laser passed through an endoscope

If the tissue is severely abnormal or has become cancer, you may have surgery to remove part of your esophagus.

How can I take care of myself and help prevent Barrett’s esophagus?

  • Follow the full course of treatment prescribed by your healthcare provider.
  • Take nonprescription antacids after meals and at bedtime, according to your provider’s recommendation.
  • Take medicines with plenty of liquid. Swallowing medicine without enough liquid can irritate your esophagus.
  • Eat smaller, more frequent meals. Avoid overeating and late-evening snacks or meals.
  • Avoid drinking alcohol and eating foods that can make reflux worse, such as chocolate, mint-flavored foods, fatty foods, acidic foods like oranges or tomatoes, or caffeine.
  • Try to keep a healthy weight. If you are overweight, lose weight. Extra weight puts pressure on your stomach. The pressure can cause stomach contents to push up into your esophagus.
  • If you smoke, try to quit. Smoking can increase stomach acid. Smoking also increases the risk for cancer of the esophagus. Talk to your healthcare provider about ways to quit smoking.
  • Wear loose fitting clothes without belts.

It may also help if you:

  • Sit up during meals and wait at least an hour after eating before you lie down. It’s best to not eat for 2 to 3 hours before you go to bed.
  • Raise the head of your bed 6 to 8 inches by putting the frame on wood blocks. If you cannot raise the frame of the bed, try placing a foam wedge under the head of your mattress. Sleeping on your left side may also help. Just using extra pillows will not help.
  • Chew sugarless gum after meals. Some studies have shown that this decreases reflux.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

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Published by RelayHealth.
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