Barrett's esophagus occurs when the lining of the tube that carries food from the mouth to the stomach, known as the esophagus, is damaged and begins to look more like the lining of the intestine, according to the National Digestive Diseases Information Clearinghouse, or NDDIC. The condition does not have any symptoms itself, though it is often caused by acid reflux, in which stomach acid leaks into the esophagus. Reflux can cause heartburn symptoms. Barrett's esophagus can cause further precancerous changes in the cells lining the esophagus, called dysplasia, which can lead to cancer.
Monitoring
Patients with Barrett's esophagus require frequent monitoring to be sure that the condition hasn't progressed to dysplasia or cancer, according to MedlinePlus. This may involve an endoscopy, in which a small tube with a camera and a light on the end is inserted through the mouth and down through the esophagus. A special instrument is used to take small samples of the Barrett's tissue to check for dysplasia and cancer. Biopsies should be done at least every three years, according to the American Society for Gastrointestinal Endoscopy.
Photodynamic Therapy
If severe dysplasia or cancer is found, doctors will try to remove the damaged area, according to MedlinePlus. Photodynamic therapy is just one way to do it. In this procedure, a light-sensitive drug is injected into the patient. Then a laser is inserted into the esophagus and used to activate the drug to destroy the Barrett's tissue. Complications include chest pain, nausea, light sensitivity and scarring, according to the NDDIC. Once the damaged area is removed, healthy tissue should grow back.
Endoscopic Mucosal Resection
In an endoscopic mucosal resection, the Barrett's lining is lifted away from the rest of the esophagus with suction or by injecting a solution under it, according to the NDDIC. Then the Barrett's tissue is cut off and removed with the endoscope so that healthy tissue can grow back. Complications include bleeding or tearing the esophagus. Sometimes this procedure is used in combination with photodynamic therapy.
Surgery
Surgical removal of most of the esophagus is often recommended for those with severe dysplasia or cancer so long as they can tolerate a surgical procedure, according to the NDDIC. It can give the patient the best long-term chance of survival. In this procedure, most of the esophagus is cut out and a piece of the stomach is pushed up through the chest to attach to what remains of the esophagus.
