Barrett’s Esophagus

What is Barrett’s esophagus?

Barrett’s esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, undergoes significant changes. Its normal lining is replaced by cells similar to those in the intestine. Although Barrett’s esophagus itself may not cause symptoms, it is closely linked to the risk of developing esophageal cancer, especially in people with gastroesophageal reflux disease (GERD).

Normal esophageal function

The esophagus has an important function: to transport food, liquids and saliva from the mouth to the stomach. The stomach functions as a sort of storage, where the digestion of food begins, which is then sent to the intestine for further digestion. Digested food is absorbed by the intestine through a process called peristalsis, which is imperceptible to us. When these contractions are intense, they can cause discomfort, especially if hot or cold solid foods or liquids are ingested.

Sphincter mechanisms

The muscular layers of the esophagus are narrowed at both ends by circular muscles called “sphincters.” When a person swallows, the sphincters relax to allow food to pass through. After passage, the sphincters close to prevent food from flowing back into the esophagus and into the mouth. A phenomenon known as reflux occurs when the sphincters relax and a small amount of food or liquid flows back into the esophagus.

What is GERD?

Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently backs up into the esophagus. Although it does occur sometimes, frequent and uncontrolled reflux is a sign of a health problem that requires medical attention. Typical symptoms include heartburn and may be caused by obesity, certain foods, or pregnancy.

Reflux and Barrett’s Esophagus

Although the exact cause of Barrett’s esophagus is unknown, reflux is thought to play a role. Barrett’s esophagus is more common in men and whites, and is relatively rare in children.

Cancer Risk

Barrett’s esophagus is a precursor to esophageal adenocarcinoma. The risk of developing cancer is 30 to 125 times higher in people with Barrett’s esophagus than in those without the disease. The increase in esophageal adenocarcinoma is linked to obesity and gastroesophageal reflux.

troubleshooting

Barrett’s esophagus can only be diagnosed by endoscopy (gastroscopy). During this procedure, your doctor may perform a biopsy if suspicious mucus is noted. Patients over age 40 with GERD are recommended to have an endoscopy every two years to monitor changes.

Treatment

There is no drug cure for Barrett’s esophagus. Surgical removal of the affected area is an option, especially for patients at high risk of cancer. Many specialists recommend treatment of gastroesophageal disease, but this measure does not guarantee prevention of cancer development.

Observation for dysplasia and cancer

Periodic endoscopies are important to monitor changes in patients with Barrett’s esophagus. If dysplasia develops, the process must progress to an intermediate stage where cancer cells appear in the esophageal tissue, and this is only confirmed by biopsy.

Important research questions

There are several areas that require further study, including:

• Method for identifying individuals with problems.
• Causes of Barrett’s esophagus.
• Treatments to prevent or eliminate it.
• Optimal treatments for patients with Barrett’s esophagus or cancer.

Conclusion

Some important things to remember are:

• In Barrett’s esophagus, the cells change and become similar to those in the intestine.
• It is closely related to GERD.
• A small number of patients with Barrett’s esophagus may develop esophageal cancer.
• Diagnosis is made through endoscopy and biopsy.
• Patients are advised to undergo periodic endoscopy.
• Taking antacids can help, but should be done under the supervision of a doctor.
• Surgical removal is recommended only for patients at high risk of cancer.

It is hoped that this information will help raise awareness of Barrett’s esophagus and the risks associated with it.