Barrett’s esophagus is condition in which cells lining the esophagus are abnormal. The esophagus is a long muscular tube that moves food down from the mouth to the stomach. At its lower end is a small band of muscle (sphincter) that prevents stomach acid from moving back up into the esophagus (reflux). Cells called squamous (flat) cells normally line the esophagus. In Barrett’s esophagus, these cells become another type, called columnar (cells that look like columns). About 5% to 10% of people with this disorder develop cancer of the esophagus.
The cause is unknown, but it is thought to start from chronic acid reflux disease. It can occur in 10% to 15% of people with acid reflux. It is not hereditary and is not spread from person to person.
Most symptoms are similar to those in people with acid reflux or acid indigestion. Heartburn is characteristic and usually occurs at night, often waking people from sleep.
Other symptoms include chest pain, difficulty swallowing, food getting stuck or having to vomit food, shortness of breath, wheezing, laryngitis, and hoarseness.
The doctor usually diagnoses the disorder by using endoscopy (placing a lighted tube into the mouth and down into the esophagus). The doctor examines the esophagus and can take samples of any possible problem areas (by a biopsy, or removing a small piece of tissue for study under a microscope).
The goal is to prevent acid from refluxing into the esophagus. This protects the esophageal lining and may prevent development of Barrett’s esophagus. Drugs can limit the amount of acid reaching the lining. These drugs including antacids, H2-antagonists (e.g., ranitidine, famotidine), proton pump inhibitors (e.g., omeprazole, lansoprazole), and medicines that improve gastrointestinal motion (e.g., metoclopramide). Proton pump inhibitors are most effective and preferred.
The major complication is development of esophageal cancer, but the health care provider can monitor the esophagus by frequent endoscopy to check for cancer. Other complications include bleeding from ulcers and narrowing (stricture) of the esophagus.
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