GERD and Barrett’s Esophagus
Acid reflux occurs when acid
backs up from the stomach into the esophagus. This causes symptoms such as chest
pain or heartburn, stomach pain, or a dry cough. Chronic acid reflux is known
as gastroesophageal reflux disease (GERD).
Symptoms of GERD are often
overlooked as minor. However, chronic inflammation in your esophagus can lead
to complications. One of the most serious complications is Barrett’s esophagus.
Barrett’s esophagus is thought to
be the result of chronic inflammation. In some people with GERD, the acid
irritates the esophagus so greatly that a change in the tissue lining the
esophagus starts to take place. This change is called metaplasia. Metaplasia is
a process when one type of cell is replaced with another. Esophageal cells are
replaced with cells more like those seen in the intestines.
No unique symptoms are associated
with Barrett’s esophagus, but the symptoms of acid reflux can persist.
Barrett’s is usually found in
people with GERD. However, according to the National Center for Biotechnology Information (NCBI), it only affects about 5 percent of reflux patients.
According to the Mayo Clinic, certain
factors may put you at higher risk for Barrett’s esophagus. These include:
- being male
- having GERD for at least 10 years
- being white
- older age
Can You Develop
Cancer from Barrett’s Esophagus?
Barrett’s esophagus increases the
risk of esophageal cancer. However, this cancer is rare even in people with
Barrett’s esophagus. According to the NCBI, statistics
have shown that over a period of 10 years, only 10 out of 1,000 people with
Barrett’s will develop cancer.
If you are diagnosed with
Barrett’s esophagus, your doctor may want to watch for early signs of cancer.
You will need regularly scheduled biopsies. Examinations will look for
precancerous cells. The presence of precancerous cells is known as dysplasia.
Regular screening tests can
detect cancer at an early stage. Early detection prolongs survival. Detecting
and treating precancerous cells may even help prevent cancer.
There are several treatment
options for Barrett’s esophagus. Treatment depends on whether or not you have
People with No or Low-Grade Dysplasia
If you don’t have dysplasia, you
may just need surveillance. This is done with an endoscope. An endoscope is a
thin, flexible tube with a camera and light.
Doctors will check your esophagus
for dysplasia every year. After two negative tests, this can be extended to
every three years.
You may also be treated for GERD.
GERD treatment can help keep acid from further irritating your esophagus.
Possible GERD treatment options include:
- dietary changes
- lifestyle modifications
People with High-Grade Dysplasia
Treatment is different with
serious dysplasia. The goal is to remove the precancerous cells. This can be
done in several ways. All methods carry a risk of serious side effects. Discuss
the risks in detail with your physician before deciding on a treatment.
Potential treatments include the following:
- Endoscopic mucosal resection is performed using an endoscope.
Damaged areas of the esophageal lining are cut away and removed.
- Photodynamic therapy uses light to destroy precancerous
cells. First the cells are sensitized with medication. Then they are
exposed to light using an endoscope.
- Cryotherapy uses an endoscope to freeze abnormal
cells, resulting in cell death.
- Radiofrequency ablation uses energy to destroy cells in your
esophagus. A special balloon
inserted into your esophagus heats up and kills the abnormal cells.
- Surgery can also be used to remove your
esophagus. However, this can have particularly serious complications. It’s
usually considered a last resort.
Diagnosis and treatment of GERD
may help to prevent Barrett’s esophagus. It may also help keep the condition