Barrett's Esophagus

Overview

Barrett’s esophagus is a condition in which the lining of the esophagus is replaced with tissue that is similar to the lining of the intestine. This condition can occur when the esophagus is exposed to stomach acid for an extended period, and is more common in those with gastroesophageal reflux disease (GERD), a chronic condition that can cause stomach acid to be regurgitated into the esophagus.

Barrett’s esophagus is relatively rare, affecting around 6% of people in the United States. Because Barrett’s Esophagus doesn’t usually display noticeable symptoms, many of those who have the condition may not know they have it.

Barrett’s esophagus can increase a person’s risk of developing a rare cancer called esophageal adenocarcinoma. For this reason, those diagnosed with GERD should also be screened for Barrett’s esophagus.

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Why Hoag for Barrett’s Esophagus Evaluation and Treatment?

Because both can lead to a deadly form of esophageal cancer, a diagnosis with GERD or Barrett’s esophagus is not to be taken lightly. You need to address it, and you need a team with the experience, techniques and expertise to make a fast, accurate diagnosis that can chart your treatment path.

In Orange County, Hoag’s comprehensive, fully-integrated Foregut Program offer all that you need when it comes to treating serious or recurring conditions of the esophagus and stomach. Our program offers a patient-centered approach, drawing on the latest advancements in techniques and technology to help patients find answers other programs might miss. The result: better outcomes, and fuller recoveries.

Need treatment for Barrett’s esophagus in Orange County? Hoag is here for you every step of the way.

Symptoms and Causes of Barrett’s Esophagus

Barrett’s esophagus usually does not cause any noticeable symptoms, which means many people with the condition don’t know they have it. Typically, Barrett’s esophagus is discovered accidentally during an endoscopic procedure — in which doctors use a small, flexible camera to examine the esophagus and/or stomach — that’s being performed for other reasons.

Risk Factors

The reason why some people develop Barrett’s esophagus while others don’t is not understood yet. What is known, however, is that Barrett’s esophagus is much more common in people with gastroesophageal reflux disease (GERD), a chronic (long-term) form of gastroesophageal reflux. Between 10-15% of people with GERD develop Barrett’s esophagus.

People with GERD may experience symptoms including heartburn, partial regurgitation of food, difficulty swallowing or chest pain. The primary cause of Barrett’s esophagus is long-term exposure of esophageal tissues to stomach acid, which often occurs in people with GERD. Common symptoms of GERD include:

  • Recurring heartburn
  • Regurgitation, which involves stomach contents coming back up through your esophagus and into your throat or mouth
  • Chest pain
  • Recurring nausea
  • Problems swallowing or pain while swallowing
  • Chronic cough
  • A hoarse speaking voice

Other risk factors that can contribute to the development of Barrett’s Esophagus include:

  • Being male, as men are much more likely as women to develop Barrett’s esophagus
  • Being over age 50, as the risk of Barrett’s esophagus increases with age
  • Being obese, because excess weight puts extra pressure on the abdomen, increasing the risk of acid reflux
  • Smoking, which weakens the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus
  • Having a family history of Barrett’s esophagus or esophageal cancer

Diagnosis and Tests for Barrett’s Esophagus

Because Barrett’s esophagus often doesn’t create noticeable symptoms, many people with the condition don’t know they have it. However, the condition is more common in people with gastroesophageal reflux disease (GERD), which usually does produce noticeable symptoms. Common symptoms of GERD include:

  • Recurring heartburn
  • Regurgitation, which involves stomach contents coming back up through your esophagus and into your throat or mouth
  • Chest pain
  • Recurring nausea
  • Problems swallowing or pain while swallowing
  • Chronic cough
  • A hoarse speaking voice

If you have symptoms of GERD, your doctor may perform an upper endoscopy to examine the lining of your esophagus. During the procedure, a specialist passes a thin, flexible tube with a camera and light at the tip through the mouth and down the throat to directly view the lining of the esophagus.

If the upper endoscopy finds evidence that you have Barrett’s esophagus, a biopsy will usually be performed to collect tissue samples for examination in a lab, both to definitively diagnose the condition and check for the presence of cancerous cells, as Barrett’s esophagus increases a patient’s risk of developing esophageal cancer.

Explore Hoag’s dedicated endoscopy centers located near you

Advanced Diagnosis of Conditions of the Esophagus and Stomach at Hoag

As Orange County’s recognized leader in the accurate diagnosis and treatment of conditions involving the stomach and esophagus, the Hoag Digestive Health Institute is here for those facing serious conditions involving these crucial digestive organs, including GERD, Barrett’s esophagus and esophageal cancer.

At Hoag, advanced procedures used to diagnose or treat conditions involving the stomach and esophagus include:

Management and Treatment for Barrett’s Esophagus

The management of Barrett’s esophagus depends on the severity of the condition and whether or not you have dysplasia, which are abnormal cells in the esophagus. If dysplasia is not present, treatment may focus on managing GERD and acid reflux to prevent further damage to tissues of the esophagus.

Some treatment options include:

  • Surveillance, in which your doctor will schedule regular upper GI endoscopy to watch the condition closely for signs of cancer
  • Medications to reduce acid reflux. These potentially include proton pump inhibitors and H2 blockers, which are medications that reduce the amount of acid in the stomach, lowering the risk of acid reflux.
  • Endoscopic procedures to remove abnormal cells. One procedure that might be employed, for example, is radiofrequency ablation which uses radio waves to heat and kill abnormal cells in the esophagus.
  • Surgery is rarely needed for Barrett’s esophagus, but it may be recommended in severe cases or cases in which cancer has developed.
Advanced Treatment Options for GERD and Barrett’s Esophagus at Hoag

At Hoag, we’re committed to finding and using the latest and most advanced treatment options for conditions involving the esophagus and stomach. At Hoag, options for the treatment of Barrett’s esophagus and GERD include:

  • Enterra Therapy, which is an implantable device to control chronic nausea and vomiting often associated with gastroparesis – a condition in which the stomach cannot empty itself of food normally
  • Radiofrequency Ablation (RFA), which is a treatment that uses high-frequency electrical currents to create a small area of heat that destroys the cancer cells.
  • LINX Reflux Management System, which is an implantable, FDA-approved device that treats GERD symptoms and stops reflux. Hoag is one of only three centers in California to offer this life-changing technology.
  • Nissen Fundoplication, which is a surgery to reinforce and strengthen the lower esophageal sphincter
    Toupet Fundoplication: Anti-Reflux Surgery, which a type of anti-reflux surgery that is most often used in cases where the patient has difficulty swallowing in addition to traditional reflux symptoms.
  • Transoral Incisionless Fundoplication (TIF), which is a minimally invasive, non-surgical procedure that corrects a weakened esophageal sphincter, which causes chronic gastroesophageal reflux disease (GERD). The TIF procedure is performed entirely within the stomach, using an endoscope passed down the throat, and requires no incisions.

Prevention of Barrett’s Esophagus

  • Maintain a healthy weight, as obesity puts extra pressure on the abdomen, increasing the risk of acid reflux and Barrett’s esophagus.
  • Quit smoking, because smoking weakens the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus.
  • Limit alcohol consumption, as alcohol can increase the production of stomach acid, increasing the risk of acid reflux and Barrett’s esophagus.
  • Avoid foods that trigger acid reflux, such as spicy or acidic foods

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