If you've been diagnosed with Barrett's esophagus, you may be wondering what it is, how it's treated, whether it can progress to cancer and what you should eat or avoid. Here are some tips to give you the best chance of preventing cancer from developing if you have Barrett's esophagus.
What Is Barrett’s Esophagus?
Your esophagus is the tube that transmits food from your mouth to your stomach. With Barrett's esophagus, the healthy cells that line the area where the esophagus meets the stomach are replaced with cells similar to those that line your intestine — a process known as metaplasia_,_ which means "normal cells found in an abnormal location," explains Gregory Ginsberg, MD, a professor of medicine at the Hospital of the University of Pennsylvania.
Doctors think the main culprit in the development of Barrett's esophagus is gastroesophageal reflux disease (GERD), according to the American Society for Gastrointestinal Endoscopy (ASGE). GERD is when stomach acid refluxes upward into the esophagus, causing chronic inflammation.
Read more: What to Eat for an Irritated Esophagus
Barrett’s Esophagus and Cancer
A risk of Barrett's esophagus is that it can develop into adenocarcinoma of the esophagus, a form of cancer, although it is rare, says Dr. Ginsberg. Less than 0.5 percent of people with Barrett's esophagus develop it each year, according to the ASGE.
But it's important not to ignore symptoms like heartburn or difficulty swallowing. If you have these symptoms, your doctor will conduct an endoscopy to look at your esophageal lining by inserting a thin, lighted tube into your esophagus. A small tissue sample will be removed and examined under the microscope to help determine whether you have Barrett's esophagus and whether it might progress to cancer, the ASGE says.
A clue that esophageal tissue is becoming precancerous is the presence of dysplasia_,_ a kind of "cellular disarray," Dr. Ginsberg says. If dysplasia is found, it's categorized as low-grade, high-grade or cancer. How serious the dysplasia is will help determine the type of treatment you need.
Treating Barrett’s Esophagus
There are two important goals in treating Barrett's esophagus: controlling GERD symptoms and preventing progression to cancer, according to Dr. Ginsberg. Your doctor may prescribe medications called proton pump inhibitors, which reduce acid production in the stomach so there's less acid rising into the esophagus.
People with Barrett's esophagus but without dysplasia should be regularly monitored to make sure dysplasia isn't developing and to catch cancer before it becomes too advanced to treat. People with high-grade and some with low-grade dysplasia may need surgery or endoscopic procedures to decrease the potential development of cancer, says Dr. Ginsberg.
Using Diet to Maximize Esophageal Health
Although changing your diet doesn't guarantee that Barrett's esophagus won't become cancerous, avoiding certain habits like overeating, drinking too much alcohol and eating too much fat can be helpful in reducing acid reflux, Dr. Ginsburg says. The ASGE also advises avoiding chocolate, coffee, tea, peppermint, citrus, tomato juice, red meat, processed foods and carbonated beverages, which can worsen reflux.
Eliminating certain foods is important, but it's also helpful to eat more foods that can reduce inflammation. Dr. Ginsberg encourages eating more fiber, including whole grains such as brown rice, oatmeal and foods with bran. Fruits and vegetables, especially leafy, dark green veggies, are rich in vitamins, minerals and fiber and can have anti-inflammatory effects, according to an article published in Advances in Nutrition in July 2012.
Read more: The 10 Worst Foods for Acid Reflux
Eating close to bedtime can worsen reflux because acid can rise while you're lying flat. It may help to sleep at an angle by putting bricks or blocks under the head of your bed to raise it, according to a review published in February 2016 in Clinical Gastroenterology and Hepatology.
Is This an Emergency?
- American Society for Gastrointestinal Endoscopy: “Understanding Barrett’s Esophagus”
- American Cancer Society: “Esophageal Cancer Risk Factors. Health Risks of Smoking Tobacco”
- Advances in Nutrition: “Health Benefits of Fruits and Vegetables”
- Clinical Gastroenterology and Hepatology: “Lifestyle Intervention in Gastroesophageal Reflux Disease”
- Gregory G. Ginsberg, MD, professor of medicine at the Hospital of the University of Pennsylvania