The esophagus is a muscular tube that runs from the back of the mouth to the stomach. As the muscles of the esophagus contract, food is moved downward into the stomach. The esophagus is lined with mucus membranes that help the food move smoothly into the stomach. Over time, the lining changes to look more like that of the stomach and small intestine. This change is called intestinal metaplasia.
Bile is a golden brown or greenish yellow, bitter-tasting fluid produced by the liver. It flows to the small intestine through the bile ducts. Bile plays a role in how fat is absorbed by the body. It is also partially responsible for making the contents of the stomach less acidic as they move into the small intestine.
Roughly one in 10 patients with gastro-esophageal reflux disease (GERD) will develop Barrett's esophagus.
The risk factors include:
- Being older than 50
- Being male. Barrett's esophagus is three to four times more common in men than women
- Being white (Caucasian). Barrett's is more common in Caucasians than African Americans
- Having chronic heartburn
- Having GERD
Persons with Barrett's esophagus may be at higher risk for developing cancer of the esophagus. Although the risk is relatively low, once Barrett's esophagus is identified the patients should discuss the treatment plan with their physician.
The symptoms are the same as those of gastro-esophageal reflux disease:
- Heartburn, a burning sensation under the breast bone
- Stomach acid flowing backward into the throat or mouth
- Having a bitter or sour taste in the mouth
- Nausea in the morning
- Sensation of something stuck in the throat
- A feeling of food getting stuck with swallowing, like a scar or a tumor
To make a diagnosis, a doctor will use upper GI endoscopy to see the lining of the esophagus. Endoscopy is a technique in which a camera on a tube is inserted in the body allowing the doctor to directly see the esophagus.
Tissue samples can be taken at the same time. This will confirm the diagnosis and make sure that there are no signs of cancer.
The procedure may need to be done on a regular basis after the diagnosis to make sure that cancer isn't developing. How often the exam should be done depends on how severe the condition is.
There is no medicine that can cure Barrett's esophagus. Medical treatment lowers stomach acid, which injures the esophagus.
Cedars-Sinai offers Barrx® Treatment for Barrett's esophagus. This minimally invasive procedure is effective in treating the condition in most cases.
Some newer therapies that can be tried under special circumstances are:
- Radiofrequencing therapy that uses high frequency energy to burn away the abnormal living cells. Normal cells replace those destroyed by the treatment
- Removal of abnormal pieces of the esophagus lining with upper GI endoscopy. It is being used to treat early esophagus cancer or conditions likely to become cancer.