Barrett's esophagus is a disorder in which the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid. Barrett's is present in 10 percent of patients with acid reflux. If you have chronic heartburn, your doctor may recommend an upper endoscopy to examine you for Barrett's esophagus, which in some cases can lead to cancer.
MedStar Georgetown is one of just a handful of hospitals nationally that offers the full range of expertise and technology available to provide chronic heartburn sufferers with the latest, least invasive and most successful treatment options.
Our doctors regularly conduct advanced GI diagnostic studies such as endoscopy, esophageal pH monitoring and impedance testing as well as esophageal motility.
- The Center for Endoscopic Excellence and the Center for Gastrointestinal Motility and Heartburn to learn more about diagnostic testing
- Visit the Center for Esophageal Diseases to learn more about treatment
How Barrett's Esophagus Occurs
Acid reflux can occur when stomach acid leaks into the esophagus. This reflux can cause symptoms of heartburn and can damage the lining of the esophagus. This is called reflux or Gastroesophageal Reflux Disease (GERD).
The acid reflux that causes Barrett's esophagus often leads to symptoms of heartburn. The hallmark symptoms of GERD are:
- Heartburn: a burning sensation in the chest and throat
- Regurgitation: a sensation of liquid contents that have backed up in the esophagus
However, many patients with this condition do not have symptoms.
Diagnosis of Barrett's Esophagus
If GERD symptoms are severe or they come back after treatment, your doctor will recommend three tests:
- Endoscopy – a thin tube with a camera on the end is inserted through your mouth and then passed into your esophagus and stomach. While looking at the esophagus with the endoscope, the doctor may perform biopsies in different parts of the esophagus. These biopsies help diagnose Barrett's esophagus, as well as look for changes that could lead to cancer.
- PH monitoring tests – these tests help your doctor track the amount of acid entering your esophagus. Diagnostic pH testing are performed through the Center for Gastrointestinal Motility and Heartburn. One state-of-the-art test called the BRAVO ph monitor utilizes a tiny vitamin size probe that transmits pH information to a receiver during a 24–48 hour period. MedStar Georgetown also offers impedance pH monitoring, the only pH diagnostic testing modality which monitors for acid and non-acid reflux.
- Esophageal motility – Dr. Caren Palese and Dr. Stanley Benjamin of the Center for Gastrointestinal Motility and Heartburn will evaluate through esophageal manometry testing how your esophagus is moving food down toward your. Esophageal manometry evaluates for swallowing problems, reflux or esophageal spasms. Our medical team will insert a thin tube through your mouth and esophagus to determine your esophagus' pumping strength and the effectiveness of the valve between your esophagus and stomach. The test typically takes 30 to 60 minutes and patients do not need to stay in the hospital overnight.
Learn more about MedStar Georgetown's Center for Gastrointestinal Motility and Heartburn.
Treatment of Barretts
Treatment of gastroesophageal reflux disease should improve symptoms of reflux and may keep Barrett's esophagus from getting worse.
Lifestyle changes to reduce symptoms of Gastroesophageal Reflux Disease (GERD) include:
- Avoiding dietary fat, chocolate, caffeine and peppermint because they may cause lower esophageal pressure and allow stomach acid to flow backwards
- Avoiding alcohol and tobacco
- Avoiding lying down after meals
- Losing weight
- Sleeping with the head of the bed elevated
- Taking medications with plenty of water
Medications to relieve symptoms and control GERD include:
- Proton pump inhibitors
- Antacids after meals and at bedtime
- Histamine H2 receptor blockers
- Promotility agents (medications that speed digestion, emptying the stomach faster to reduce the chance of acid washing into the esophagus)
Anti-reflux surgery may help with symptoms of GERD but will not cause Barrett's esophagus to disappear.
Medical Intervention of Barrett's Esophagus
Your doctor may recommend surgery or other procedures if a biopsy shows cellular changes that are likely to lead to cancer. Such changes are called severe or high-grade dysplasia. Some of these procedures remove the harmful tissue in your esophagus, where the cancer is most likely to develop.
- Barrx – a radiofrequency ablation (burning of diseased tissue) inside the esophagus
- Endoscopic Mucosal Resection to treat early Barrett cancer and dysplasia
- Surgery to remove the abnormal tissue
Visit the Center for Esophageal Diseases to learn more about treatment options.