Causes and Risks:

Irritation of the lining of the esophagus by gastric acid secretions is the probable cause. The condition occurs more frequently in men than women. Risk factors are frequent and longstanding gastroesophageal reflux. An increased risk of developing cancer of the esophagus is present with this condition.

Prevention:

Diagnosis and treatment of gastroesophageal reflux may prevent the onset of Barrett’s esophagus.

Symptoms:

• heartburn
• burning pain under the sternum
  • increased by bending or stooping
  • increased by eating
  • relieved by milk or antacids
  • worse or frequent at night
• difficulty swallowing

Signs and Tests:

Looking at the esophagus with an endoscope and obtaining a sample of esophagus tissue for examination (esophagoscopy with biopsy) reveals Barrett’s esophagus.

Treatment:

Treatment includes general measures to control gastroesophageal reflux, medications, and surgery.

General measures include:

• weight reduction
• avoiding lying down after meals
• sleeping with the head of the bed elevated
• taking medication with plenty of water
• avoiding dietary fat, chocolate, caffeine, and peppermint because they may cause lower esophageal pressure
• avoiding alcohol and tobacco

Medications to relieve symptoms and control gastroesophageal reflux include antacids after meals and at bedtime, Histamine H2 receptor blockers, proton pump inhibitors, cholinergic agents, and pro motility agents.

Surgery to remove a portion of the esophagus (resection of the esophagus) may be indicated if a biopsy shows the type of cellular changes that tend to lead to cancer (dysplasia).

Prognosis:

An increased risk of esophageal cancer is present. Follow-up endoscopy to look for dysplasia or cancer is often advised.

Complications:

• esophageal dysplasia
• esophageal cancer

Call for an appointment with your health care provider if symptoms of heartburn persist for longer than a few days or you have pain or difficulty swallowing.

Call for an appointment with your health care provider if symptoms worsen, do not improve with treatment, or if new symptoms develop in a person with Barrett’s esophagus.