Barrett's Esophagus: Definition, Causes, Symptoms, Diagnosis, and Treatment

By Cristiano Antonino On May 9, 2023

Barrett’s esophagus means that some cells in the lining of the food pipe have started to change. In a small number of people these cells can develop into cancer of the esophagus over a long period of time

The cells lining the food pipe are normally flat.

They are called squamous cells.

In Barrett’s esophagus, they change into a type more like columnar (column-shaped) cells in the lining of the small and large intestine.

Cells can grow abnormally.

Doctors call this dysplasia.

Dysplasia can be low-grade or high-grade.

The grade indicates the abnormal appearance of the cells under a microscope.

The more abnormal they look, the higher the grade.

Barrett’s esophagus can increase the risk of cancer of the esophagus, although the risk is still low.

Many people with Barrett’s esophagus do not develop cancer.

Between 3 and 13 out of 100 people (between 3 and 13%) with Barrett’s esophagus will develop esophageal adenocarcinoma in their lifetime.

And each year, fewer than 1 in 100 people with Barrett’s (less than 1%) develop esophageal adenocarcinoma.

Your risk of developing esophageal cancer is higher if you have more severe cell changes (high-grade dysplasia).

Barrett’s esophagus is more common in men than in women.

And it is also more common in older people.

Other risk factors include:

have a history of acid reflux symptoms
being overweight and the fat is mostly around the waist (abdominal obesity)
Many people with Barrett’s esophagus have no symptoms at all
Doctors can find the changes in your cells when you have tests for something else.

Indigestion and long-term heartburn are the most common symptoms.

Many people have indigestion and heartburn and it usually doesn’t mean anything is wrong.

But see your GP for a check if you have indigestion most days for 3 weeks or more or if it is getting worse.

You may also have difficulty swallowing food.

Or food may come back up from the stomach into the food pipe, but this is less common.

This test looks inside the food pipe to find any changes.

Use a long hose with a light on the end.

Some treatments aim to control symptoms and reduce the risk of abnormal cells turning into cancer.

They lower the amount of acid produced by the stomach.

Other treatments remove or treat damaged areas in the lining of the food pipe.

The management of Barrett’s esophagus depends on your situation.

Management options include:

monitor your condition – this is called surveillance
medicines to stop stomach acid
surgery to strengthen the food pipe valve
removing the affected area through an endoscope – this is called endoscopic mucosal resection (EMR)
destroy the affected area by radiofrequency ablation (RFA)
surgery to remove the area containing the affected cells
other treatments to destroy the abnormal cells, such as light therapy (photodynamic therapy) or freezing treatment (cryotherapy)