Barrett's esophagus is a condition where the inner squamous lining of the esophagus (food pipe) is replaced by abnormal goblet and columnar cells. Present in up to 10% of people with chronic gastric reflux disease, it is believed to arise from chronic reflux induced irritation and injury from the increased peptic acid.

Barrett's esophagus does not cause any specific symptoms. Instead, symptoms are a consequence of the acid-peptic disease that underlies it. Most people with this have a long history of reflux symptoms, such as heartburn and regurgitation. Difficulty swallowing from impaired mobility of the esophagus is common. Almost 1/3 of affected people don't have symptoms that are significant, suggesting that perhaps their cells are less sensitive to acid. Up to 90% of those with Barrett's esophagus in the general population do not seek medical treatment and can go unrecognized until a complication develops, such as bleeding, stricture (narrowing), or ulceration.

Barrett's esophagus is indicative of severe gastroesophageal reflux disease and should be treated aggressively. Medication called proton pump inhibitors (Prilosec^®, Propulsid^®, Aciphex^®) is often effective in treatment. Ablation with cauterization used during endoscopy has been done successfully. Surgical treatment has also been undertaken depending on the progression of disease and symptoms.

The most serious complication of Barrett's esophagus is cancer (adenocarcinoma). This has an annual incidence of about 1%, representing a 40-fold risk compared to people without Barrett's esophagus. Virtually all adenocarcinomas of the esophagus and many tumors of the upper end of the stomach arise from Barrett's metaplasia. Those who have proven Barrett's should undergo periodic endoscopics every 2-3 years, and some more often than that if the cells themselves are particularly aggressive looking.

Prilosec^® is a registered trademark of Astra AB.
Propulsid^® is a registered trademark of Janssen Pharmaceutica, Inc.
Aciphex^® is a registered trademark of Eisai Co., Ltd., Tokyo, Japan.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.