Barrett's Esophagus Disease

Barrett's esophagus disease occurs as a complication of gastroesophageal reflux disease (GERD) in a chronic or long-term state. Many patients with Barrett's esophagus do not realize they have the disease until symptoms of GERD do not improve or additional complications present themselves. When found in the early stages, most cases of Barrett's esophagus can be monitored and controlled for many years.

Significance

• The disease is found primarily in Caucasian men where the lining and cells of the esophagus change and form a version of intestinal and gastric cells. While rare, the formation of these cells presents an increase in the risk of cancer for the patient. Most patients diagnosed with Barrett's esophagus are over the age of 60 years.

Symptoms

• The symptoms of Barrett's esophagus are similar to those of GERD and include heartburn and reflux of acid in the stomach. Reflux is when acid is regurgitated up through the esophagus and into the mouth. Additional complications produce symptoms including the onset of adult asthma, a chronic cough, and reoccurring sore throat. Patients will often have hoarseness due to acid reflux.

Causes

• Causes of the disease stem from GERD complication and include peptic ulcers and esophageal stricture from scarring in the esophagus. The scarring results in the esophagus becoming narrow and losing elasticity. The long-term effects of acid entering the esophagus prompt the onset of Barrett's esophagus.

Diagnosis

• An upper endoscopy examination is used to diagnose Barrett's esophagus. This examination requires the patient to be sedated while a physician inserts a thin, flexible endoscope to study the stomach and esophagus. Tissue samples are collected during the procedure and studied to determine if the cells are abnormal and cancerous. If changes to the cells cannot be determined, testing will be conducted every six months to monitor any changes.

Treatment

• There are no treatments available that will reverse Barrett's esophagus. A physician will treat the GERD to slow the complications that result. Medications presently being taken by the patient will be examined, as some may make the lower esophageal sphincter weak, allowing acid and stomach contents up into the esophagus. A patient should eat smaller meals and not eat three hours prior to bedtime. Smoking and alcohol consumption should be avoided, along with eating fatty, spicy and high-acid foods such as citrus and tomato products. Overweight patients should lose weight, as it reduces the stress and pressure on the stomach and sphincter. Acid-reducing medications called proton pump inhibitors may assist with reducing acid content in the stomach. These medications include Prilosec, Prevacid, Nexium, Zantax and Tagamet. Surgery to limit the amount of acid entering the esophagus is done in extreme cases.