Diseases & Conditions
At Boston Medical Center, we pride ourselves on the ability to diagnose and treat esophageal disorders using the most advanced therapies. We do this in an environment of caring and compassion, where our priority is the well-being of you and your family.
Virginia Litle, MD, Director, Barrett's Esophageal Program
What is Barrett's Esophagus (BE)?
Barrett’s Esophagus (BE) is a complication of chronic gastroesophageal reflux disease (GERD). The normal valve between the esophagus and stomach is incompetent and stomach fluid causes changes in the type of cells in the esophagus. The normal squamous epithelial cells of the esophagus become metaplastic and look like intestinal cells under the microscope. The appearance of the esophageal lining on upper endoscopy can be suggestive of BE, but the actual diagnosis of BE is made after looking at the esophageal cells under a microscope in the pathology lab.
BE is estimated to occur in 2 – 5.6 % of people in the United States. BE is a known risk factor for precancerous dysplasia, which can then progress to esophageal adenocarcinoma (EAC). EAC develops in about 0.5% of people with BE annually. BE increase the risk of esophageal adenocarcinoma by 11-40 times when compared to patients without BE. When patients are diagnosed with BE, they are advised to enter a surveillance program of repeat endoscopies on a regular schedule to look for precancerous dysplastic changes or early esophageal cancer. The survival rate of all patients presenting with EAC is 15% at five years, but when EAC is diagnosed early, then cure is possible.
What are the Symptoms?
Typical symptoms of GERD include heartburn and regurgitation. BE occurs in about 10% of U.S. adults with heartburn. GERD however can be silent that is without heartburn or regurgitation, and BE can result in the absence of symptoms. In addition a loss of typical GERD symptoms like heartburn can be suggestive of the development of BE.
Barrett's esophagus patients may have symptoms of:
- Heartburn and regurgitation
- Unexplained weight loss or loss of appetite
What are the Causes?
Barrett's esophagus is thought to be caused mainly by gastroesophageal reflux disease (GERD), which is persistent reflux occurring at least twice a week. Patients generally experience a feeling of heartburn or acid indigestion, and they may taste food or fluid in the back of the mouth. The use of over-the-counter or prescription acid-reducing drugs may decrease the risk of Barrett's esophagus.