What is the definition of Barrett Esophagus?

Barrett esophagus is a condition in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is replaced by tissue that is similar to the lining of the intestines. Although this change does not cause any specific signs or symptoms, it is typically diagnosed in people who have long-term gastroesophageal reflux disease (GERD). The exact underlying cause of Barrett esophagus is not known; however, it generally occurs sporadically in people with no family history of the condition. Treatment varies by the severity of the condition and generally includes medications and life style modifications to ease the symptoms of GERD. Endoscopic or surgical treatments may be recommended in people with severe cases.

What are the alternative names for Barrett Esophagus?

  • Barrett ulcer
  • Barrett syndrome
  • Columnar-like esophagus
  • Chronic peptic ulcer and esophagitis syndrome
  • Esophagitis-peptic ulcer
  • Barrett's esophagus

What are the causes for Barrett Esophagus?

The exact underlying cause of Barrett esophagus is unknown. However, certain factors are known to increase the risk of developing the condition. These include:
  • Long-standing gastroesophageal reflux disease (GERD)
  • Obesity (specifically high levels of belly fat)
  • Smoking

Factors that may decrease the risk include having a Helicobacter pylori (H. pylori) infection; frequent use of aspirin or other nonsteroidal anti-inflammatory drugs; and a diet high in fruits, vegetables, and certain vitamins.

What are the symptoms for Barrett Esophagus?

In people affected by Barrett esophagus, the tissue lining the esophagus (the tube connecting the mouth to the stomach) is replaced by cells that are similar to those found in the lining of the intestines. This change does not cause any specific signs or symptoms. However, Barrett esophagus is typically diagnosed in people who have long-term gastroesophageal reflux disease (GERD). GERD may be associated with symptoms such as frequent heartburn, difficulty swallowing food, and/or chest pain (less commonly).

People with Barrett esophagus do have a greater risk than the general population of developing esophageal cancer. However, the overall risk is still low as less than 0.5 percent of people with Barrett esophagus develop cancer of the esophagus each year.

What are the current treatments for Barrett Esophagus?

The treatment of Barrett esophagus largely depends on the severity of the condition as determined by the level of dysplasia seen on biopsy. In people with no dysplasia or low-grade dysplasia, treatment is often focused on easing the signs and symptoms of gastroesophageal reflux disease (GERD), which can cause further damage to the esophagus. This may include certain medications and lifestyle modifications such as avoiding smoking; eliminating food and drinks that trigger heartburn; raising the head of the bed while sleeping; and/or avoiding late night snacking. Periodic endoscopy may also be recommended to monitor Barrett esophagus as other treatments may be indicated if the condition advances.

Because high-grade dysplasia is thought to be the final step before cells change into esophageal cancer, more aggressive treatments are typically recommended. These may include:[
  • Endoscopic resection - an endoscope is used to remove damaged cells
  • Endoscopic ablative therapies - different techniques such as photodynamic therapy or radiofrequency ablation are used to destroy the dysplasia in the esophagus. In photodynamic therapy, abnormal cells are destroyed by making them sensitive to light, while radiofrequency ablation uses heat to remove abnormal esophagus tissue.
  • Surgery - the damaged part of the esophagus is removed and the remaining portion is attached to the stomach

The National Institute of Diabetes and Digestive and Kidney Diseases' (NIDDK) Web site offers more specific information on the treatment and management of Barret esophagus. Please click on the link to access this resource.

What is the outlook (prognosis) for Barrett Esophagus?

The long-term outlook (prognosis) for people with Barrett esophagus is generally good. In many cases, treatment improves acid reflux symptoms and keeps Barrett esophagus from getting worse.

People with Barrett esophagus do have a greater risk than the general population of developing esophageal cancer. However, the overall risk is still low as less than 0.5 percent of people with Barrett esophagus develop cancer of the esophagus each year.

How is Barrett Esophagus diagnosed?

Esophagogastroduodenoscopy (EGD) with a biopsy is the procedure of choice for confirming a diagnosis of Barret esophagus. A diagnosis is often made while investigating other conditions such as gastroesophageal reflux disease (GERD).

Based on the biopsy, a doctor will be able to determine the severity of the condition, which can help inform treatment decisions. The sample may be classified as:
  • No dysplasia - a diagnosis of Barrett's esophagus is confirmed, but no precancerous changes are found in the cells
  • Low-grade dysplasia - the cells show small signs of precancerous changes
  • High-grade dysplasia - the cells show many precancerous changes. This is thought to be the final step before cells change into esophageal cancer

The National Institute of Diabetes and Digestive and Kidney Diseases' (NIDDK) Web site offers more specific information on the diagnosis of Barret esophagus. Please click on the link to access this resource.

Is Barrett Esophagus an inherited disorder?

Barrett esophagus usually occurs sporadically in people with no family history of the condition. In rare cases, it can affect more than one family member; however, it is unclear whether these cases are due to common environmental exposures or an inherited predisposition (or a combination of the two).

One study found that some people with Barrett esophagus who go on to develop esophageal adenocarcinoma have changes (mutations) in the MSR1, ASCC1, and/or CTHRC1 genes. However, additional studies are needed to confirm these findings.
  • Condition: Gastroesophageal Reflux Disease
  • Journal: JAMA
  • Treatment Used: Lifestyle Modification, Proton Pump Inhibitor Medication, and Laparoscopic Fundoplication
  • Number of Patients: 0
  • Published —
The study researched the outcomes of treatment for gastroesophageal reflux disease.
  • Condition: Dysplastic Barrett's Esophagus and Early Esophageal Neoplasia
  • Journal: Cancer control : journal of the Moffitt Cancer Center
  • Treatment Used: Cryotherapy Ablation
  • Number of Patients: 405
  • Published —
In this study, researchers evaluated the outcomes of using only cryotherapy for the treatment of dysplastic or neoplastic Barrett's esophagus.
Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Device
  • Participants: 1350
  • Start Date: January 1, 2022
Minimally Invasive Molecular Approaches for the Diagnosis of Barrett's Esophagus and Esophageal Adenocarcinoma
Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Device
  • Participants: 15
  • Start Date: January 30, 2021
The Effect of Positional Therapy on Symptoms of Gastroesophageal Reflux Disease: A Prospective Pilot Study