Barrett’s esophagus is a condition of the lower esophagus in which the flat, thin cells that form the esophageal lining transform into acid-resistant cells resembling those found in the intestines. This transformation is thought to be caused by the cells’ repeated exposure to acidic stomach contents washing back (refluxing) through the lower esophageal sphincter due to its malfunction. This persistent acid reflux is commonly known as GERD, or gastroesophageal reflux disease, and is widespread in American adults.

Barrett’s esophagus, however, is relatively rare, with only a small portion of those suffering from GERD developing the disease. Barrett’s is thought to be a pre-cancerous condition, meaning that those who suffer from it are at greater risk of developing a certain type of esophageal cancer called an adenocarcinoma.

Signs and Symptoms of Barrett’s Esophagus

Barrett’s esophagus does not cause any symptoms by itself. It is considered noteworthy because it is considered a precursor for a type of esophageal cancer called an adenocarcinoma.

Diagnosis of Barrett’s Esophagus

In order to determine if you have Barrett’s esophagus, your physician may require you to undergo one or more tests. These may include:

• Biopsy – A sample of tissue is removed from the patient and examined to determine whether or not it is abnormal..
• Upper Endoscopy – this procedure allows a physician to look inside the esophagus, stomach, and duodenum (part of the small intestine). During an upper endoscopy, the patient swallows a thin lighted tube called an endoscope, which transmits an image to a television monitor, so the physician can examine the lining of these organs. A biopsy may be performed during this procedure.

Treatment Options

Surgery – there is no true cure for Barrett’s esophagus other than surgery, though this is rare and typically recommended in situations where the condition is likely to lead to cancer. In this case, surgery may be used to remove a portion of the esophagus in a procedure known as an esophagectomy..

Though there is no cure for Barrett’s other than surgery, there are several non-surgical treatments, including:

• Porfimer sodium photodynamic therapy (PDT) – in this procedure, a drug called porfimer sodium is injected into the patient’s body, where it makes all the tissues, including the abnormal cells in the esophageal lining, sensitive to light. A non-heat producing laser light is passed down the esophagus and directed onto the abnormal cells. The laser light activates the drug, causing the abnormal tissue to be destroyed by a photochemical reaction.
• Thermal Ablation Therapy – as with PDT, thermal ablation is an attempt to destroy abnormal cells in the lower esophagus. Rather than light, however, thermal ablation therapy uses direct heat to burn off the Barrett’s lining.
• Endoscopic Mucosal Resection (EMR) – this procedure involves using a flexible tube with a light attached called an endoscope to remove part of the Barrett’s lining, much like colon polyp removal. Unlike an esophagectomy, which removes the entire affected area, an EMR only removes a small cancer or locally high-grade area of abnormal cells.