More than one-third of adults experience gastroesophageal reflux disease, or GERD, at some point during their lives. GERD occurs when the ring of muscle at the end of your food tube, or esophagus, doesn’t work properly and allows stomach acid to flow back into your esophagus to cause irritation. Left untreated, GERD can lead to complications such as Barrett’s esophagus.
Understanding Barrett’s Esophagus
Barrett’s esophagus occurs when the cells lining your esophagus change to resemble those lining your intestine. Research has yet to reveal the exact cause of these changes, but evidence suggests that they may be your body’s way of trying to protect your esophagus from acid exposure. Unfortunately, the presence of Barrett's esophagus is associated with a 30-fold increase in risk of developing esophageal cancer over the general population. Barrett's esophagus is found in about 10% of patients who suffer from chronic GERD.
Risk Factors for Barrett’s Esophagus
Risk factors for development of Barrett's esophagus include age over 50, male sex, Caucasian race, chronic reflux and obesity.
Symptoms of Barrett’s Esophagus
By itself, Barrett’s esophagus causes no symptoms. If present, symptoms are related to underlying reflux and may include heartburn, regurgitation, chest pain, trouble swallowing, chronic cough and hoarseness.
Diagnosing Barrett’s Esophagus
If you have persistent GERD symptoms, you’ll need to schedule an EGD or upper endoscopy. An upper endoscopy involves passing an endoscope — a lighted tube with a camera at the tip — down your throat to check for changes to your esophagus. Normal esophageal tissue is pale and uniform in color. In patients with Barrett’s esophagus, the tissue is a salmon pink color instead.
If the endoscopy reveals evidence of Barrett’s esophagus, your physician will take a biopsy. A biopsy involves removing a small sample of the abnormal tissue for closer inspection under a microscope. The results of this test will help determine the best treatment for your condition and better define your risk for developing cancer of the esophagus.
Treating Barrett’s Esophagus
Treatment for Barrett’s esophagus depends on whether dysplasia is present and to what degree. Dysplasia is a change in the cells that signifies a progression towards cancer. If you have no dysplasia, your physician may recommend antacid medication and lifestyle changes to treat your GERD symptoms. You’ll also require a repeat upper endoscopy and biopsy in one year and then again every three years if no dysplasia occurs. If you have low to high-grade dysplasia, your physician may recommend antacid medications in addition to ablation procedures to remove the abnormal tissue. You will also require more frequent upper endoscopy procedures to monitor the Barrett's esophagus.
The best course of action is working with your doctor to control the symptoms upfront. Contact us if you would like to make an appointment to talk about your GERD and Barrett's esophagus concerns.