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Digestive system
Digestive system
Esophagus and stomach anatomy
Esophagus and stomach anatomy

Barrett’s esophagus
Definition:
A disorder in which the lining of the esophagus (the tube which carries food from the throat to the stomach) has cellular changes caused by irritation from stomach acid which has leaked into the esophagus. This leakage of acid is commonly known as "heartburn" (gastroesophageal reflux).

Causes, incidence, and risk factors:

Irritation of the lining of the esophagus by gastric acid secretions (stomach acid) causes Barrett's esophagus. It occurs more frequently in men than women. Risk factors are frequent and long-standing gastroesophageal reflux (heartburn). The condition carries an increased risk of cancer of the esophagus.
Symptoms:
  • heartburn
  • burning pain under the sternum
    • increased by bending or stooping
    • increased by eating
    • relieved by milk or antacids
    • worse or frequent at night
  • difficulty swallowing
Note: Patients with this condition may not experience any symptoms.
Signs and tests:

Looking at the esophagus with an endoscope and obtaining a sample of esophagus tissue for examination (esophagoscopy with biopsy) reveals Barrett's esophagus.
Treatment:

Treatment includes general measures to control gastroesophageal reflux, medications, and surgery. Treatment may be important even if the patient doesn't feel any symptoms.

General measures include:

  • weight reduction
  • avoiding lying down after meals
  • sleeping with the head of the bed elevated
  • taking medication with plenty of water
  • avoiding dietary fat, chocolate, caffeine, and peppermint because they may cause lower esophageal pressure
  • avoiding alcohol and tobacco

Medications to relieve symptoms and control gastroesophageal reflux include antacids after meals and at bedtime, Histamine H2 receptor blockers, proton pump inhibitors, cholinergic agents, and promotility agents.

Surgery to remove a portion of the esophagus (resection of the esophagus) may be indicated, if a biopsy shows the type of cellular changes that tend to lead to cancer (dysplasia).
Expectations (prognosis):

An increased risk of esophageal cancer is present. Follow-up endoscopy to look for dysplasia or cancer is often advised.
Complications:
Calling your health care provider:

Call your health care provider if symptoms of heartburn persist for longer than a few days, or you have pain or difficulty swallowing.

Call your health care provider if symptoms worsen, do not improve with treatment, or if new symptoms develop in a person with Barrett's esophagus.
Prevention:

Diagnosis and treatment of gastroesophageal reflux may prevent the onset of Barrett's esophagus.
Review Date: 9/23/2002
Reviewed By: A.D.A.M. editorial. Previous review: Jenifer K. Lehrer, M.D., Department of Gastroenterology, Graduate Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network (5/1/2002).
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