What is Barrett’s Esophagus?
While many people diagnosed with Barrett’s esophagus have long-standing GERD, many have no reflux symptoms but a condition often called “silent reflux.” It affects approximately one-half of the adult population in the United States.
The esophagus and cells are not designed to be exposed to chronic acid and other stomach contents that frequently happen with GERD. Instead, Barrett’s esophagus occurs when the inner lining of the esophagus and cells have changed, so they are no longer equipped to handle the acidic environment. It happens when the pink lining of the esophagus becomes damaged by acid reflux, causing that lining to thicken and become red and damaged.
This is a precancerous condition that predisposes patients to esophageal adenocarcinoma. However, not to get alarmed, it is low risk and is similar to a polyp found in the colon. Therefore, patients with Barrett’s esophagus should have a surveillance endoscopy every three to five years as a precautionary measure.
The lower esophageal sphincter is a critically important valve between the esophagus and the stomach. Often over time, it may fail, leading to acid and chemical damage to the esophagus.
Who needs screening for Barrett’s Esophagus?
Any person that has a history of acid reflux symptoms should be screened! Unfortunately, there are no consensus guidelines on when people should undergo a screening endoscopy like there are with colonoscopies.
Once a patient has been diagnosed with Barrett’s esophagus, they are placed in a surveillance program.
Although the chance of developing esophageal cancer is slight, it’s essential to have regular checkups with careful imaging and esophagus biopsies if necessary.
In addition, your medical professional will schedule appointments required to check for precancerous cells, also known as dysplasia.
If or when precancerous cells are discovered, they can be treated to prevent esophageal cancer.
How Do I Get Tested for Barrett’s Esophagus?
Screenings for Barrett’s Esophagus:
• Endoscopy: a procedure that is nonsurgically used to examine an individual’s digestive tract. Doctors use a flexible tube with an attached camera with a light called an endoscope, enabling them to view pictures of the patient’s digestive tract.
• Optical endomicroscopy: is an enhanced imaging technology that provides a real-time diagnosis of intestinal metaplasia or dysplasia. This procedure can often reduce the need for tissue biopsy.
• Brush biopsies: soft-bristled brushes are rubbed over a wide area of the esophageal mucus membrane, increasing the number of cells collected for biopsy.
What is Dysplasia?
The current understanding of Barrett’s esophagus involves several steps before it develops into esophageal adenocarcinoma. This change is also called dysplasia. With regular Barrett’s esophagus without dysplasia, esophageal cells are still normal-looking, and intestinal cells have a typical architecture.
With dysplasia, Barrett’s esophagus cells appear abnormal and no longer look similar to one another. The changes can be classified as low-grade up to high-grade, increasing the risk of developing esophageal adenocarcinoma.
What are the Symptoms?
Developing Barrett’s esophagus is often attributed to long-term GERD. These symptoms may include these signs:
• Heartburn and regurgitation of stomach contents
• problem swallowing food
• Less commonly, chest pain or uncomfortableness
Approximately one-half of the people diagnosed with Barrett’s esophagus report little or no symptoms of acid reflux. Therefore, it would be best if you spoke with your digestive health doctor regarding the possibility of developing Barrett’s esophagus.
When should I see a doctor?
If you’ve had trouble with regurgitation, heartburn, and acid reflux for more than five years, address your digestive professional about your risk of Barrett’s esophagus.
Seek help immediately if you:
• Have chest pain, which may be a symptom of a heart attack
• Have difficulty swallowing
• Have red blood or blood that looks like coffee grounds in your vomit
• Are passing black, tarry, or bloody stools
• Have unintentional weight loss
Whether this acid reflux is accompanied by GERD symptoms, stomach acid and chemicals wash back into the esophagus, damaging esophagus tissue and triggering changes to the lining of the swallowing tube, causing Barrett’s esophagus. Your Doctor can discuss changes that can be made in lifestyle and eating habits that can help reduce your risk or symptoms.
How is Barrett’s Esophagus treated?
Barrett’s esophagus without dysplasia is usually monitored with an upper endoscopy and biopsies every three to five years. This procedure helps monitor the possible progression to dysplasia or even cancer.
Typically no treatment is necessary for Barrett’s esophagus other than controlling acid exposure to the esophagus. This can be done by medication or potentially with anti-reflux surgery. Once dysplasia occurs, this is typically treated with radiofrequency ablation (RFA). RFA is minimally invasive and works by using heat to ablate the esophagus lining to eradicate the abnormal cells.
This treatment significantly decreases the risk of progression to cancer.
Dr. Jefferey Snow, M.D., P.A. has been one of America’s Top Surgeons three years in a row, and four years in a row was honored as one of Miami Metro Magazine’s Best Doctors in South Florida. Being a senior partner at Surgery Specialists of South Broward for 20 years. He has been active in hospital medical staff leadership throughout his career, having held positions such as Chief of Staff and Vice Chief of Staff. He has chaired several essential hospital committees over the years.
Dr. Jeffrey Snow has been a senior partner at Surgery Specialists of South Florida for 20 years and has spent his entire career practicing medicine in South Florida. Dr. Snow is a board-certified general and colorectal surgeon.
If you have any questions please call our office: (954) 237-1123