Barrett’s Esophagus is a serious complication of GERD, or GastroEsophageal Reflux Disease, which affects the lining of the esophagus (the tube that carries foods and liquids from your mouth to your stomach). For those with Barrett’s Esophagus, the normal tissue lining the esophagus changes to resemble the lining of the intestine due to the injury caused by the stomach acid and enzymes refluxing into the esophagus. Over time, this damage can result in inflammation and genetic changes that can cause the esophagus cells to become altered. About 10-15 percent of people with chronic symptoms of GERD develop Barrett's Esophagus. If you have GERD more than twice a week, you should consult your physician or call the Akron General Heartburn Center for an evaluation.
Barrett’s Esophagus does not have any specific symptoms, although people with Barrett’s Esophagus may have symptoms related to GERD. It does increase the risk of developing esophageal cancer, which is a serious, potentially fatal cancer of the esophagus. Although the risk of esophageal cancer is higher in people with Barrett’s Esophagus, it is still rare, with less than 1 percent developing esophageal cancer. However, if you have been diagnosed with Barrett’s Esophagus it is important to have routine examinations and biopsies of your esophagus. With routine exams, physicians have the opportunity to find precancerous and cancer cells early, when the disease is easier to treat.
For patients with Barrett’s Esophagus, a physician will perform an upper endoscopy procedure with a biopsy. Endoscopy is a non-surgical test that sends light and images to a video screen from a tiny flexible tube (endoscope) that you swallow. Endoscopy is performed under sedation and allows the doctor to see if there are any problems as the scope moves from the throat, through the lower esophageal sphincter (LES) and into the stomach. The doctor will take a sample of tissue, called a biopsy, which will be sent to pathology for evaluation.
Treatment options for Barrett’s Esophagus
Recommendations from medical societies advise that patients with Barrett’s Esophagus should, at a minimum, undergo an upper endoscopy with biopsies procedure on a regular basis for the remainder of their lifetime. The frequency of endoscopy is determined by the severity of Barrett’s Esophagus.
In addition to surveillance endoscopy, there is an endoscopic treatment option to eliminate Barrett’s tissue completely, called ablation. Ablation is a technique where tissue is heated or frozen until it is no longer alive. Barrett’s Esophagus tissue is very thin so it is a good candidate for removal with ablative energy. Physicians have used various forms of ablation for nearly a century to treat a number of cancerous and pre-cancerous conditions, as well as to control bleeding. The ablation technique Akron General uses to treat Barrett’s Esophagus uses heat energy, delivered in a precise and controlled manner, without damaging the normal underlying structures.
Ablation therapy is done on an outpatient basis. Patients are sedated and the procedure is carried out via endoscopy, meaning that no incisions are made. Patients may experience some chest discomfort and difficulty swallowing hard or crusty foods for several days, but both are managed with medications and a temporary diet adjustment. Patients are also sent home with additional post-treatment instructions and Heartburn Center physicians and staff are always available to answer any other questions.
Successful elimination of Barrett’s esophagus tissue does not cure GERD or the associated symptoms. Other options for the management of GERD will be individualized for each patient.