Barrett's esophagus

Barrett's esophagus is a condition in which some of the lining of the esophagus is replaced by abnormal cells. The esophagus is the tube through which food passes from the throat to the stomach. Barrett's esophagus is a precancerous condition.

 

The esophagus is connected to the stomach by the esophageal sphincter. This is a muscular ring. Normally, this muscle performs two major functions. It opens to allow food to pass into the stomach, then closes to keep the contents of the stomach from splashing back up into the esophagus.

 

If this sphincter weakens or relaxes too often, the contents of the stomach splash back up into the esophagus. This splashing is known as gastroesophageal reflux disease, or GERD. The cells lining the esophagus are sensitive to injury by stomach acid, and after being exposed over a long period of time, they become damaged.

 

This change in the lining of the lower esophagus is called Barrett's esophagus.

 

Sometimes the damaged cells lining the esophagus cause a narrowing of the opening known as an esophageal stricture. A person with this condition might have trouble swallowing food.

 

Barrett's esophagus itself does not cause symptoms. However, people with this condition almost always have symptoms from GERD, though development of Barrett's esophagus may cause chronic GERD symptoms to go away, since this lining is less sensitive.

 

GERD causes burning pain under the breastbone or in the upper abdomen. This pain is often called heartburn. It may increase when the person eats, bends over, or lies down. Antacids usually relieve the pain. Pain may increase at night or cause a person to wake up during the night. Other symptoms of GERD include the following:

 

GERD is the major cause of Barrett's esophagus. Recent evidence suggests that it may also have some genetic, or inherited predisposition. One-third of all people with scleroderma, a skin disorder, develop Barrett's esophagus.

The best way to prevent Barrett's esophagus is to diagnose and treat GERD as early as possible.

The diagnosis of Barrett's esophagus begins with a medical history and physical examination. The healthcare provider may then order an esophagoscopy. A thin tube with a light and camera attached to it is passed down into the esophagus. This allows a doctor to look at the inside lining of the esophagus directly through the endoscope. A small sample of the esophageal lining can be removed and examined with a microscope. This is called esophagoscopy with biopsy.