Barrett’s esophagus is a condition where the tissue lining of the esophagus changes into columnar cells, increasing the risk of cancer. It is caused by chronic acid reflux or GERD and is diagnosed through an upper gastrointestinal endoscopy. Treatment includes lifestyle changes, medication, and surgery.
Barrett’s esophagus is a relatively silent and uncommon disease that can be a precursor to several serious conditions. While anyone can develop it, those at greatest risk are men, Caucasians, Hispanics, and the elderly. One in ten people who suffer from gastroesophageal reflux disease (GERD) will develop Barrett’s esophagus.
Little is known about the transformation, or metaplasia, that occurs in the tissue lining of the esophagus that results in Barrett’s esophagus. The squamous (flat) cells of the esophagus change into columnar (column-shaped) cells. Of the three possible columnar cell types that can develop in the esophagus, one is recognized as the one found in the small intestine. This particular type of intestinal cell is known as Barrett’s esophagus and has the potential to turn into cancer.
Although there are speculations as to why Barrett’s esophagus develops into these columnar cells, most researchers believe that the damaged squamous cells cause the transformation. Chronic acid reflux, or its successor, GERD, produces stomach acids that burn the lining of the esophagus. This transformation begins during healing and the new cells show columnar characteristics.
The sphincter muscle at the junction of the esophagus and stomach keeps acids in the stomach to digest food. A weakened sphincter or hiatus hernia allows these acids to back up into the esophagus. Based on genetics, some people are predisposed to the condition. With the acidic lifestyle and diets of Western civilization, many in our society have experienced heartburn from time to time. GERD is a more complex condition that causes these acids to backwash into the esophagus more consistently, resulting in tissue damage.
Symptoms of GERD include excessive acid reflux, belching, coughing, difficulty swallowing, chronic heartburn, regurgitation of food, sore throat, hoarseness and trouble breathing. This chronic regurgitation of acids into the lower esophagus is what exposes the tissues. You should consult a doctor if any of these symptoms persist for an extended period.
Barrett’s esophagus has no subjective symptoms. An upper gastrointestinal endoscopy is the only way to correctly diagnose the condition. The lining of the esophagus and stomach is viewed by inserting a flexible telescope down the esophagus. A biopsy is taken for examination to confirm the condition. The salmon-red visual appearance of the esophagus, which is normally pale pink in color, also occurs through endoscopy.
People diagnosed with Barrett’s esophagus have a higher than average risk of developing cancer of the esophagus. This is why it is important to explore the possibility if the patient has chronic GERD or other acid reflux complications. Surveillance endoscopy is recommended to be repeated at intervals of one to three years.
Most patients diagnosed with Barrett’s esophagus are treated for acid reflux or GERD. These treatments do not reverse the columnar cells but will help prevent further erosion of healthy tissue. In the early 2000s, experimental treatments began burning these columnar cells with laser surgery in hopes that the healing process would return the cells to their original state.
Home treatments of Barrett’s esophagus involve lifestyle and dietary changes. Lose weight, stop smoking, eat smaller more frequent meals, avoid acidic foods that trigger heartburn, find a good antacid or herbal remedy that relieves acid reflux, lift your head while sleeping, avoid bending over or stooping and wearing loose clothing are good options that can relieve GERD symptoms and reduce acid production.
Most people who have Barrett’s esophagus and GERD require more aggressive treatments. Prescription drugs, surgery to tighten the sphincter, laser surgery of damaged tissue, or partial or complete removal of the esophagus is a final option. In extreme cases where the patient shows a high rate of abnormal cells (dysplasia), removal of the esophagus is recommended. If high levels of dysplasia are found, it may be an indication that cancer is already present.
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