Barrett's esophagus is a complication that can result from gastroesophageal reflux disease, or GERD, a form of severe heartburn that damages the inner lining of the esophagus. It is not a common condition, but it can lead to esophageal cancer and therefore should be taken seriously.
Definition
In Barrett's esophagus, the lining of the esophagus changes and becomes more like the intestinal lining. This change commonly occurs as a result of GERD, a condition in which acidic contents from the stomach move back into the esophagus to cause frequent heartburn. According to the Mayo Clinic, Barrett's esophagus may be the result of changes in cellular structure after attempts by the esophagus to repeatedly heal itself after recurring bouts of acid reflux.
Causes and Risk Factors
The biggest risk factor for developing Barrett's esophagus is having gastroesophageal reflux disease. It is most commonly found in individuals who developed GERD when they were young and who have had the disease for many years. According to the American Society for Gastrointestinal Endoscopy, 10 to 15 percent of people with GERD will go on to develop Barrett's esophagus. Men are more at risk for Barrett's esophagus than women, as are individuals over 50. Caucasians have a higher rate of Barrett's esophagus than people of other races. Smoking and obesity can also increase the risk for Barrett's esophagus.
Diagnosis
To diagnose Barrett's esophagus, a doctor performs an endoscopy, a procedure in which he uses a tube inserted through the mouth and into the throat, esophagus and stomach to determine any visually apparent problems that can be seen via an attached external monitor. The visual changes of Barrett's esophagus show up as a change in color and composition of the esophageal cells. A biopsy will be taken at the same time as the endoscopy or soon afterward if the endoscopy results indicate the possibility of Barrett's esophagus. The biopsy can be analyzed at a lab either under a microscope or through chemical tests.
Complications
Barrett's esophagus can lead to adenocarcinoma of the esophagus, a type of esophageal cancer. However, the development of cancer from tissue affected by Barrett's esophagus is rare and most people with the condition never get esophageal cancer.
Treatment
Treatment of Barrett's esophagus is difficult, as there are no completely effective treatments of the disease itself. Medication and surgery can be used to treat GERD, which reduces the risk of developing Barrett's esophagus. The condition can also be monitored to watch for the development of precancerous or cancerous cells, which can then be promptly treated or removed. An experimental treatment is sometimes used which destroys the damaged tissue via an endoscope, a procedure called endoscopic mucosal resection, but the effectiveness of this procedure is not yet established. Other treatments that can destroy affected esophageal tissue include photodynamic therapy, which uses light to destroy cells after administering medication to make those cells sensitive to light, and radiofrequency ablation, which uses bursts of heat administered through electrodes to kill damaged cells, or surgery.
