What you need to know about Barrett's Esophagus?
Chronic acid reflux can be very damaging to a person’s esophagus and can lead to a precancerous condition called Barrett’s Esophagus. The flat, thin lining of the esophagus is not designed to handle stomach acid. In Barrett’s esophagus, the cells in the lining of the esophagus change and become thickened and inflamed. Long-term inflammation is associated with a risk of cancer. According to the American Cancer Society, approximately 20,000 people will develop esophageal cancer this year. This type of cancer has been most often seen in people aged 65 or older; however, recent studies have shown the esophageal cancer rate among people ages 45 to 64 have nearly doubled.
The primary risk factor for Barrett’s esophagus is prolonged acid reflux; however, other factors include smoking, alcohol consumption, and obesity. All of these factors contribute to the irritation and inflammation of the esophagus.
Although there are no symptoms of Barrett’s esophagus, signs that are associated with this condition are heartburn, burning in the back of the throat, regurgitation, persistent cough, difficulty swallowing food, laryngitis, and nausea.
Curiously, approximately half of the people diagnosed with Barrett's esophagus report little if any symptoms of acid reflux. So, you should discuss your digestive health with your doctor regarding the possibility of Barrett's esophagus.
When to see a doctor
If you've had trouble with heartburn, regurgitation and acid reflux for more than five years, then you should ask your doctor about your risk of Barrett's esophagus.
Seek immediate help if you:
Have chest pain, which may be a symptom of a heart attack
Have difficulty swallowing
Are vomiting red blood or blood that looks like coffee grounds
Are passing black, tarry or bloody stools
Are unintentionally losing weight
Because the symptoms of Barrett’s esophagus are similar to gastroesophageal reflux disease, individuals with chronic acid reflux should be screened. The American Gastroenterological Association recommends screenings for those with multiple risk factors, specifically:
over the age of 50
long history of GERD
history or current smokers
Barrett’s esophagus can be diagnosed by upper endoscopy and a biopsy. An upper endoscopy is performed by inserting a thin, flexible tube into the esophagus to look for changes in the lining of the esophagus. If the tissue is suspect, then a biopsy is taken during the procedure. The sample is then analyzed by a pathologist to determine the condition of the tissue.
If your healthcare provider identifies Barrett’s esophagus without the presence of precancerous cells, there is no treatment necessary. Screenings every 2-3 years will be recommended. If your healthcare provider identifies Barrett’s esophagus and a biopsy revealed minimal precancerous cells, you will need more frequent screenings and possible ablation therapy (removal of damaged tissue using hot or cold energy during endoscopy) .
If your healthcare provider identifies Barrett’s esophagus with a substantial amount of precancerous cells, your treatment may consist of removing the damaged tissue through cryotherapy, radiofrequency ablation, mucosal resection, or esophagectomy.
Treating acid reflux and lifestyle changes greatly reduces the likelihood of developing Barrett’s esophagus or esophageal cancer. To keep the lining of the esophagus healthy, control acid reflux or eliminate the factors that contribute to reflux and irritation: smoking, alcohol, obesity
Photo Courtesy: Mayo Foundation for Medical Education and Research