What Is Barrett’s Esophagus?
Barrett’s esophagus is a condition in which chronic gastroesophageal reflux disease (GERD) causes the normal squamous lining of the esophagus to be replaced by intestinal‑type cells. This metaplastic change increases the risk of developing esophageal adenocarcinoma. Barrett’s esophagus often has no symptoms of its own; it arises in the setting of long‑standing reflux and is typically discovered during an endoscopy performed for GERD.
Risk Factors
- Chronic, untreated GERD.
- Age over 50.
- Male gender.
- Caucasian ethnicity.
- Obesity, particularly central (abdominal) obesity.
- Smoking history.
Surveillance and Diagnosis
Barrett’s esophagus is diagnosed during an upper endoscopy with biopsies to confirm intestinal metaplasia. Once diagnosed, regular surveillance endoscopy is recommended to monitor for dysplasia (precancerous changes). The frequency of surveillance depends on whether dysplasia is present and the degree of abnormality.
Treatment and Ablation
- Acid suppression: Proton pump inhibitors to control reflux and reduce esophageal irritation.
- Endoscopic ablation: When low‑grade or high‑grade dysplasia is detected, endoscopic therapies can eradicate abnormal cells. Techniques include radiofrequency ablation (RFA), cryotherapy, and photodynamic therapy.
- Endoscopic resection: For nodular or focal lesions, endoscopic mucosal resection (EMR) removes the abnormal tissue for analysis and treatment.
- Surgery: Rarely, esophagectomy may be needed for extensive high‑grade dysplasia or early cancer.
Our team provides comprehensive management of Barrett’s esophagus, including advanced surveillance and endoscopic ablation, to reduce cancer risk while preserving esophageal function.