Barrett’s esophagus is normally diagnosed in those who have had a hard run with gastrointestinal issues and long-term gastroesophageal reflux disease. In Barrett’s esophagus, the tissue in the cylinder-like muscle that connects your stomach to your mouth is replaced by tissue that is like what is found in your intestinal lining. Barrett’s esophagus is associated with an increased risk of developing esophagus and stomach cancer. It is very important to have regular check-ups with your medical care team if you deal with serious gastrointestinal issues to ensure that no precancerous cells are developing.
What are the causes and risk factors for developing Barrett’s esophagus?
While there is no direct cause of Barrett’s esophagus, most all of those formally diagnosed have dealt with long-term acid reflux issues or GERD. GERD is also referred to as gastroesophageal reflux disease and many call it, ‘severe heartburn.’ With GERD, the contents of the stomach flow back into the esophagus, permanently damaging the esophageal tissue. As the esophagus attempts to repair itself, the cells lining the tissues can change into the type of cells found in Barrett’s esophagus. There are certain cases in which the person does not have any heartburn or symptoms, and still has this issue.
Certain things that can increase your risk for developing Barrett’s esophagus are:
-Current or past smoking and any form of tobacco use.
-Being overweight and carrying extra body fat around your abdomen increases your risk.
-Being a man because men are more prone to this issue than women.
-Being Caucasian, as white people are stricken with Barrett’s esophagus more than other races or cultures. This does not mean that someone who is Asian or African American cannot get Barrett’s esophagus; this only refers to the statistical outcomes from the WHO in 2017.
-Having chronic heartburn and acid reflux does not get better when taking medications known as proton pump inhibitors. If you have GERD that requires regular medications to help ease the symptoms, these medications have also been linked to the development of Barrett’s esophagus.
Other complications linked to Barrett’s esophagus can include issues with nausea and vomiting, weight loss, stomach pain and discomfort, and Gastroparesis.
How is Barrett’s esophagus diagnosed?
As with many gastrointestinal issues and testing, the diagnosis of Barrett’s esophagus is done via endoscopy. An endoscopy is a procedure where a thin tube with a camera on the end is passed through your mouth and down into your stomach and is able to view your esophagus on the way down. Your doctor can check for abnormalities and tissue differences. With Barrett’s esophagus, the tissue is red and velvety, whereas normal tissue appears to be pale and glossy. Your doctor might take a biopsy during this procedure to examine for any degree of change.
A pathologist, or tissue expert, can look at the biopsy and cells to determine the degree of dysplasia within your esophagus cells that were extracted. It can be complicated to diagnose different levels of dysplasia in the cells, so getting another opinion from a specialist is okay when needed. The pathologist might determine your tissues have:
–High-grade dysplasia happens when the cells show they are soon-to-be changing into esophageal cancer.
–Low-grade dysplasia is diagnosed if a small sign of precancerous changes have occurred.
–No dysplasia is diagnosed when Barrett’s esophagus is present, but no precancerous chances have yet occurred.
Are there any screening tests that can be done to prevent or stop Barrett’s esophagus?
For those who are diagnosed with GERD and are having trouble finding a treatment that works or have extended use with any proton pump inhibitor medication, along with two or more risk factors, should consider regular tests to check for Barrett’s esophagus. Women who are experiencing severe heartburn or acid reflux that is not completely controlled by these medications should also be screened for Barrett’s esophagus.
What is the treatment for Barrett’s esophagus?
The treatment for this issue depends on the degree of the abnormal cells in your esophagus and your overall health. If you were diagnosed with no dysplasia, your treatment might be:
-periodic endoscopies to monitor the cells in your esophagus to check for chances or abnormalities.
-Treatment for your GERD condition which might include medication and lifestyle changes. This could also mean surgery to tighten the sphincter that controls the flow of stomach acid in the stomach and esophagus. Treating GERD does not mean that Barrett’s esophagus will not happen, as these medications have been linked to the development of the disease.
If you were diagnosed with low-grade dysplasia, your treatment might include:
-a repeat endoscopy in six months, with additional follow-ups every six months.
-endoscopic resection which involves using an endoscope and removing the damaged cells.
-Radiofrequency ablation which involves using heat to remove the damaged and abnormal cells. This is often paired with endoscopic resection.
If there is marked inflammation in the esophagus with the first endoscopy, another endoscopy may be performed three or four months after to recheck and verify if treatment is working.
If you were diagnosed with high-grade dysplasia, your treatment may include:
-Surgery to remove the damaged part of your esophagus and the reconnection of the esophagus back to the stomach with the remaining, healthy tissue.
-Photodynamic therapy is a light therapy that destroys abnormal cells by exploiting their light sensitivity.
-Cryotherapy utilizes the endoscopic procedure and administers a cold liquid or gas to the abnormal cells in the esophagus. The cells are warmed, and then frozen again. The cycle of repetitious heating and freezing destroys any abnormal cells.
Barrett’s esophagus can reoccur at any time, even after treatment. If you suspect you may be dealing with this condition, check in with your medical care team and schedule an appointment to begin testing. Begin to change your home routine to avoid the specific things that can trigger these cells to become damaged. This includes maintaining a healthy weight, stopping smoking, eliminating foods like coffee, alcohol, chocolate, and fried foods along with raising the head of your bed can all help with symptoms until you can get a new treatment plan started. Be sure to note your questions and take them to your appointment with you to discuss them with your doctor.
Citations:
Mayo Health
American Cancer Society
GI Institute
GutAlive