All About Barrett’s Esophagus
Our Radio Frequency Ablation service is here to provide a minimally-invasive treatment to patients with Barrett’s Esophagus. Here’s what you need to know about the condition:
What is Barrett’s Esophagus?
Barrett’s esophagus is a condition in which the lining of the esophagus changes, becoming more like the lining of the small intestine rather than the esophagus. This occurs in the area where the esophagus is joined to the stomach.
It is believed that Barrett’s esophagus develops because of chronic inflammation resulting from Gastroesophageal Reflux Disease (GERD). Barrett’s esophagus is more common in people who have had GERD for a long period of time or who developed it at a young age. However, the frequency or the intensity of GERD symptoms, such as heartburn, does not increase the likelihood that someone will develop Barrett’s esophagus.
Most patients with Barrett’s esophagus will not develop cancer. In some patients, however, a precancerous change in the tissue, called dysplasia, will develop. That precancerous change is more likely to develop into esophageal cancer.
At the current time, a diagnosis of Barrett’s esophagus can only be made using endoscopy and detecting a change in the lining of the esophagus that can be confirmed by a biopsy of the tissue. The definitive diagnosis of Barrett’s esophagus requires biopsy confirmation of the change in the lining of the esophagus.
What does my doctor test for Barrett’s Esophagus?
Your doctor will first perform an imaging procedure of the esophagus using endoscopy to see if there are sufficient changes for Barrett’s esophagus. In an upper endoscopy, the physician passes a thin, flexible tube called an endoscope through your mouth and into the esophagus. The endoscope has a camera lens and a light source. It projects images onto a video monitor. This allows the physician to see any changes in the lining of the esophagus. If your doctor suspects Barrett’s esophagus, a sample of tissue (a biopsy) will be taken to make a definitive diagnosis.
Capsule Endoscopy is also used to examine the esophagus. In capsule endoscopy, the patient swallows a pill-sized video capsule that passes naturally through your digestive tract while transmitting video images to a data recorder worn on your belt. With capsule endoscopy, the physician is not able to take a sample of the tissue (a biopsy).
Both of these techniques allow the physician to view the end of the esophagus and determine whether or not the normal lining has changed. Only an upper endoscopy procedure can allow the doctor to take a sample of the tissue from the esophagus to confirm this diagnosis, as well as to look for changes of potential dysplasia that cannot be determined on endoscopic appearance alone. Barrett’s tissue has a different appearance than the normal lining of the esophagus and is visible during endoscopy.
Taking a sample of the tissue from the esophagus through an endoscope only slightly lengthens the procedure time. Your doctor can usually tell you the results of your endoscopy after the procedure, and you will have to wait a few days for the biopsy results.
Who should be screened for Barrett’s Esophagus?
Barrett’s Esophagus is twice as common in men as women. It tends to occur in Caucasian men who have had heartburn for many years. However, even in patients with heartburn, Barrett’s esophagus is uncommon and esophageal cancer is rare. While recommendations vary, patients older than 50 who have had significant heartburn or who have required regular use of medications to control heartburn for several years are most often screened. If that first screening is negative for Barrett’s tissue, there is no need to repeat it. There is a great deal of ongoing research in this area and so recommendations may change. Check with your doctor on the latest recommendations.
How is Barrett’s Esophagus treated?
Medicines and/or surgery can effectively control the symptoms of GERD. However, neither medications nor surgery for GERD can reverse the presence of Barrett’s esophagus or eliminate the risk of cancer. There are some treatments available that can destroy the Barrett’s tissue. These treatments may decrease the development of cancer in some patients and include heat (radiofrequency ablation, thermal ablation with argon plasma coagulation and multipolar coagulation), cold energy (cryotherapy), or the use of light and special chemicals (photodynamic therapy).
It is necessary to discuss the availability and the effectiveness of these treatments with your gastroenterologist to be certain that you are a candidate. There are potential risks from these treatments and they may not benefit the majority of patients with Barrett’s esophagus.
ASGE – The Source for Colonoscopy and Endoscopy