Barrett's Esophagus and GERD

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Barrett's esophagus is a disorder in which the lining of the esophagus is damaged, which can occur when parts of the esophageal lining are repeatedly exposed to stomach acid. The damaged area of the esophagus is replaced by tissue that is similar to what is found intestine. This process is called intestinal metaplasia.

The cells in the lining of the esophagus and the stomach have different functions, and are different types of cells.

Also, their appearance is very different, making it easy for a physician to tell them apart when examining the esophagus and stomach. At the end of the esophagus, there is an area that marks the border between the cells of the esophagus and the cells of the stomach. With Barrett's esophagus, abnormal intestinal-like cells develop above this border.

Diagnosing Barrett's Esophagus

Individuals who have experienced acid reflux symptoms for a number of years should undergo an upper endoscopy exam to determine if they have Barrett's esophagus. Tissue samples from abnormal looking areas of the esophagus are taken during this procedure and examined under a microscope for the presence of abnormal cells. Tissue, showing intestinal metaplasia with goblet cells, is necessary to make the diagnosis of Barrett’s esophagus.

Treating Barrett's Esophagus

The treatment options usually include medications for GERD, endoscopic ablative therapies, endoscopic mucosal resection, and surgery.

  • Medications. The use of medications for controlling acid reflux is always suggested. These medications are important because of a person's increased risk of esophageal cancer, whether or not the damaged tissue is removed.
  • Endoscopic ablative therapies. Endoscopic ablative therapies use different techniques to destroy the dysplasia (abnormal growth or development of cells, tissue, bone ) in your esophagus. After the therapies, your body should begin making normal esophageal cells. A gastroenterologist will perform these procedures at certain hospitals and outpatient centers. you will receive anesthesia to keep you sedated, comfortable and pain-free throughout the procedure. The most common procedures are the following:
    • Photodynamic therapy. Photodynamic therapy uses a light-activated chemical called porfimer (Photofrin), an endoscope, and a laser to kill precancerous cells in your esophagus. A doctor injects porfimer into a vein in your arm, and you return 24 to 72 hours later to complete the procedure.
    • Radiofrequency ablation. Radiofrequency ablation uses radio waves to kill precancerous and cancerous cells in the Barrett’s tissue. An electrode mounted on a balloon or an endoscope creates heat to destroy the Barrett’s tissue and precancerous and cancerous cells.
  • Endoscopic mucosal resection. In endoscopic mucosal resection, your doctor lifts the Barrett’s tissue, injects a solution underneath or applies suction to the tissue, and then cuts the tissue off. The doctor then removes the tissue with an endoscope. Gastroenterologists perform this procedure at certain hospitals and outpatient centers. Again, you will receive anesthesia to keep you sedated, comfortable and pain-free throughout this procedure. Before performing an endoscopic mucosal resection for cancer, your doctor will do an endoscopic ultrasound.
  • Surgery. Surgery for Barrett's esophagus is rarely done, except as a possibility in the most severe cases dysplasia, or for some types of esophageal cancers. That type of surgery is called esophagectomy. Your doctor may suggest fundoplication surgery. It doesn't treat Barrett's esophagus itself, but it has been successful in treating the underlining cause of this condition.

Treating the underlining GERD includes:

  • Avoiding drinking alcohol
  • Not wearing belts or clothes that are tight fitting around the waist
  • Taking any doctor-prescribed medications for acid reflux symptoms


Ijeoma A. Azodo, Yvonne Romero, M.D. "BARRETT'S ESOPHAGUS." American College of Gastroenterology.

"Barrett's Esophagus." NIH Publication No. 05–4546 December 2004. National Digestive Diseases Information Clearinghouse (NDDIC).

"Photodynamic Therapy for Cancer: Questions and Answers." National Cancer Institute.

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