Barrett's Esophagus

What is Barrett's Esophagus?


Barrett's esophagus is a condition in which the flat pink lining of the esophagus becomes damaged by acid reflux, which causes the lining to thicken and become red.


The lower esophageal sphincter (LES) connects the esophagus and the stomach. If the LES begins to fail, it may lead to acid and chemical damage of the esophagus, a condition called gastroesophageal reflux disease (GERD). 


GERD, which is often accompanied by symptoms such as heartburn or regurgitation, may trigger a change in the cells lining the lower esophagus, causing Barrett's esophagus.

Achalasia

Risk Factors


Barrett’s is associated with an increased risk of developing esophageal cancer. Although the incidence is low, there are factors that make the risk higher. It is therefore important to discuss findings with your health care provider to get an individualized assessment and plan.


Most people with GERD do not get Barrett’s. However, Barrett’s typically occurs in people who have had GERD for many years (>5-10 years).


Factors that increase your risk of Barrett's esophagus include:


  • Family history. Your odds increase if you have a family history of Barrett's esophagus or esophageal cancer

  • Men are far more likely to develop Barrett's esophagus

  • White people have a greater risk of the disease

  • Barrett's esophagus can occur at any age but is more common in adults over 50.

  • Chronic heartburn and acid reflux. Having GERD that doesn't get better when taking medications can increase the risk of Barrett's esophagus.

  • Tobacco/smoking - current or past

  • Alcohol

  • Being overweight


Symptoms


The development of Barrett's esophagus is most often attributed to long-standing GERD, which may include these signs and symptoms:

  • Frequent heartburn and regurgitation of stomach contents

  • Difficulty swallowing food

  • Less commonly, chest pain

Curiously, approximately half of the people diagnosed with Barrett's esophagus report little if any symptoms of acid reflux. So, you should discuss your digestive health with your doctor regarding the possibility of Barrett's esophagus.



Causes


The exact cause of Barrett's esophagus isn't known. While many people with Barrett's esophagus have long-standing GERD, many have no reflux symptoms, a condition often called "silent reflux."


Whether this acid reflux is accompanied by GERD symptoms or not, stomach acid and chemicals wash back into the esophagus, damaging esophagus tissue and triggering changes to the lining of the swallowing tube, causing Barrett's esophagus.


When to see a doctor


If you've had trouble with heartburn, regurgitation and acid reflux for more than five years, then you should ask your doctor about your risk of Barrett's esophagus.

Seek immediate help if you:

  • Chest pain

  • Difficulty swallowing

  • Vomiting red blood or blood that looks like coffee grounds

  • Passing black, tarry or bloody stools

  • Unintentionally losing weight