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Barrett's esophagus results from an irritation in the lining of the esophagus (food tube) caused by chronic reflux (flowing backward) of the contents from the stomach and small intestine into the esophagus. The irritation causes the lining of the esophagus to change and become similar to the lining of the intestine and stomach.
Barrett's esophagus does not cause signs or symptoms, but because there is a strong link between gastroesophageal reflux disease (GERD) and Barrett's esophagus, symptoms of Barrett's esophagus may be similar to those of GERD. The symptoms might include:
There are a number of risk factors for the development of Barrett's esophagus, including:
The only way to confirm the diagnosis of Barrett's esophagus is with a test called an upper endoscopy. This involves inserting a small lighted tube (endoscope) through the throat and into the esophagus to look for a change in the lining of the esophagus.
While the appearance of the esophagus may suggest Barrett's esophagus, the diagnosis can only be confirmed with small samples of tissue (biopsies) obtained through the endoscope. A pathologist will examine the tissue to make the diagnosis.
The treatment of Barrett's esophagus is similar to the treatment of GERD. Treatment might begin with lifestyle changes, including:
Treatment is also likely to include the use of medications that will decrease acid production by the stomach. Patients with Barrett's esophagus typically need prescription medications -- such as omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), rabeprozole (Aciphex®), esomeprazole (Nexium®), or dexlansoprazole (Kapidex®)-- to reduce acid. Omeprazole is now available as an over the counter preparation as well. These medications are typically given before breakfast once a day or, on occasion, before breakfast and dinner. H2 receptor antagonists are available as prescriptions or as over-the-counter medications. Tagamet®, Zantac®, Axid®, and Pepcid® are generally not as effective in decreasing the acid damage to the esophagus that causes Barrett's esophagus, but they may relieve symptoms for some patients.
All patients with Barrett's esophagus who are in reasonably good health should undergo endoscopic surveillance at appropriate intervals:
Barrett's esophagus is a premalignant (precancerous) condition that may lead to the development of cancer of the esophagus in a small number of patients. The risk of developing cancer is approximately 0.5% each year. This type of cancer is called esophageal adenocarcinoma.
Esophageal cancer develops through a sequence of changes in the cells of the esophagus known as dysplasia. Dysplasia can only be detected by endoscopic biopsies. Patients with Barrett's esophagus should have regular surveillance exams to detect cancer at an early and potentially curable stage.
Current treatments for Barrett's esophagus with dysplasia or cancer include photodynamic therapy, radiofrequency ablation, cryotherapy, endoscopic mucosal resection, or surgical removal of almost all the esophagus.
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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