Barrett's Esophagus
The esophagus is a musclar tube that runs from the back of the mouth to the stomach. As the muscles of the esophagus contract, food is moved downward into the stomach. The esophagus is lined with mucus membranes that help the food move smoothly into the stomach.
Over time, the lining changes to look more like that of the stomach and small intestine. This change is called intestinal metaplasia.
Bile is a golden brown or greenish yellow, bitter-tasting fluid produced by the liver. It flows to the small intestine through the bile ducts. Bile plays a role in how fat is absorbed by the body. It is also partially responsible for making the contents of the stomach less acidic as they move into the small intestine.
Between 3.5 to 7% of patients with symptoms of gastro-esophageal reflux disease (GERD) develop Barrett's esophagus.
The risk factors include:
- Being older than 50
- Being male. Barrett's esophagus is two to four times more common in men.
- Being white (Caucasian). Barrett's is more common in Caucasians than African Americans
- Having chronic heartburn
- Having GERD
Persons with this may be at higher risk for developing cancer of the esophagus. Although the risk is relatively low, once Barrett's esophagus is identified the patient must get regular exams from his or her doctor.
The symptoms are the same as those of gastro-esophageal reflux disease:
- Heartburn, as burning sensation under the breast bone
- Stomach acid flows backward into the throat or mouth
- Bitter or sour taste in the mouth
- Nausea in the morning
- Sensation of something stuck in the throat
- A feeling of food getting stuck with swallowing, like a scar or a tumor
To make a diagnosis, a doctor will use upper GI endoscopy to see the lining of the esophagus. Endoscopy is a technique in which a camera on a tube is inserted in the body allowing the doctor to directly see the esopahgus.
Tissue samples can be taken at the same time. This will confirm the diagnosis and make sure that there are no signs of cancer.
The procedure needs to be done on a regular basis after the diagnosis to make sure that cancer isn't developing. How often the exam should be done depends on how severe the condition is.
There is no cure for this condition. The gastro-esophageal reflux disease that causes it, however, can be treated.
Some experimental therapies that can be tried under special circumstances are:
- Photodynamic therapy, which uses laser light to destroy the abnormal lining. Normal cells replace the abnormal ones as healing takes place. Because in many cases, this does not get rid of all the abnormal lining cells, it is used only under special circumstances.
- Removal of abnormal pieces of the esophagus lining with upper GI endoscopy. It is being used to treat early esophagus cancer or conditions likely to become cancer. Its effectiveness is not yet known, so its use is limited.