What is Barrett’s Esophagus?
Barrett’s esophagus is when normal healthy cells in the esophagus are replaced by cells similar to those seen in the stomach and intestines. These cells are metaplastic (an abnormal change in the nature of the tissue) and can progress to dysplastic (pre-cancerous) or even esophageal cancer. The most common predisposing factor is gastroesophageal reflux disease (GERD). Not all patients will progress, but routine monitoring is recommended in order to find dysplastic changes early so your gastroenterolgist can intervene to halt its progression.
How is Barrett’s Esophagus Diagnosed?
In order to diagnose Barrett’s esophagus, an upper endoscopy must be performed. During this test, a small tube called an endoscope will be inserted into the throat and esophagus to look for changes in the esophageal lining. Healthy tissues will appear pale and glossy, while Barrett’s esophagus causes tissues to appear red and velvety. Small samples of tissue called biopsies will be taken, which will be examined by a pathologist in order to determine a diagnosis. The pathologist will look to see if your tissues contain abnormal cells, which is called metaplasia. Your samples will be classified as one of the following:
Barrett’s esophagus is present, but there are no signs of precancerous cells or changes in the cells.
Small signs of precancerous changes were detected in the cells.
More significant precancerous changes were detected. These patients are at the highest risk of developing esophageal cancer.
Barrett’s Esophagus Treatment Options
All patients with Barrett’s are encouraged to manage their lifestyle risk factors such as smoking cessation, and weight loss. Excellent reflux control is important and may include medications.
Further therapy depends on whether dysplasia is present. Often other factors such as length of Barrett’s, age and family history are often factored into these decisions.
Patients with Barrett’s but no dysplasia are typically followed with periodic endoscopy tests in order to pick up any advancement of the disease.
If patients have progressed to low-grade dysplasia treatment options may also include endoscopic resection and radio-frequency ablation in addition to close monitoring.
Patients with high-grade dysplasia are at particularly high risk of developing esophageal cancer. Your doctor may perform endoscopic resection, or radio-frequency ablation. In some cases surgical removal of diseased esophageal tissue may be recommended.
Barrett’s Esophagus FAQs
What is Barrett's esophagus?
Barretts esophagus is a condition where, over time, the lining of the esophagus becomes damaged with stomach acid. The acid from the stomach comes up through the esophagus. Due to the inflammation and repair cycle, the distal esophagus lining changes from squamous to columnar epithelium. This is known as metaplasia. Within the Barrett’s, dysplasia and esophageal cancer can develop.
What are the symptoms of Barrett's esophagus?
Barrett’s esophagus does not always present with symptoms. It’s important to watch for symptoms of GERD such as heartburn and acid regurgitation, which can lead to Barrett’s esophagus. If you experience frequent or chronic GERD symptoms, you should be screened for Barrett’s esophagus via an upper endoscopy. Schedule an appointment with one of South Denver GI’s highly skilled gastroenterologists. You may also have trouble swallowing or a constant sore throat.
How is Barrett's esophagus diagnosed?
To diagnose Barrett’s esophagus, an upper endoscopy is performed. During this procedure, a small tube is inserted into the throat and esophagus to look for any changes in the lining of the esophagus. A small sample or biopsy is taken. Your gastroenterologist will use WATS3D, a revolutionary type of biopsy that uses brush sampling to take sample cells from the esophagus for analysis. During laboratory analysis, artificial intelligence (AI) and 3D imaging are used to help the pathologist identify any precancerous cells. South Denver GI was the first GI practice in Denver to offer WATS3D to patients.
How is Barrett's esophagus treated?
Since Barrett’s develops in patients with GERD, it is important to manage GERD symptoms with dietary and lifestyle changes and medical therapy. Patients with Barrett’s undergo surveillance upper endoscopy with biopsies every 3-5 years to screen for dysplasia and cancer. Dysplasia is the presence of abnormal cells and is a precursor to esophageal cancer development. If dysplasia is detected, a South Denver GI physician can remove the Barrett’s tissue and dysplastic cells with radiofrequency ablation (Barrx system) to prevent cancer development. This is also done via upper endoscopy and is well tolerated.
What causes Barrett's esophagus?
Barrett’s develops in patients that have gastroesophageal reflux disease (GERD), where the stomach contents flow back into the esophagus. Not all patients will progress from GERD to Barrett’s esophagus, but routine screening is recommended in patients that have chronic GERD symptoms. To discuss whether you’re at risk for Barrett’s esophagus contact us to be seen at one of our offices in Parker, Lone Tree, Denver or Castle Rock.
How common is Barrett's esophagus?
According to John Hopkins Medicine, about 30 million people in North America have GERD, the condition that can ultimately lead to Barrett’s esophagus. About 5% of those individuals end up developing Barrett’s esophagus. It is most common among white men aged 55 and older and those who have a family history of the disease.
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