A disorder in which the lining of the esophagus (the tube which carries food from the throat to the stomach) has cellular changes caused by irritation from stomach acid which has leaked into the esophagus. This leakage of acid is commonly known as "heartburn" ( gastroesophageal reflux ).

Causes, incidence, and risk factors

Irritation of the lining of the esophagus by gastric acid secretions (stomach acid) causes Barrett's esophagus. It occurs more frequently in men than women. Risk factors are frequent and long-standing gastroesophageal reflux (heartburn). The condition carries an increased risk of cancer of the esophagus .

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. Treatment may be important even if the patient doesn't feel any symptoms. 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 promotility 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).

Expectations (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

Calling your health care provider

Call your health care provider if symptoms of

heartburn persist for longer than a few days, or you have pain or difficulty swallowing. Call your health care provider if symptoms worsen, do not improve with treatment, or if new symptoms develop in a person with Barrett's esophagus.

Prevention

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