Banishing Barrett’s Esophagus
After dinner, it’s always a struggle. You have the most wicked case of heartburn. You have difficulty swallowing food. Occasionally you experience chest pain. You may have Barrett’s esophagus.
Barrett’s esophagus is when a small percentage of patients with gastroesophageal reflux disease (GERD) find that they may have an eroded lining of the esophagus. In particular, the lining of the lower part of the esophagus. The affected area can be prone to ulceration and cancerous changes can occur in such tissue.
A normal esophagus lining has what is described as a wool-like consistency. Chronic acid reflux exposure causes gradual erosion which in time makes the lining silky-smooth.
Stomach juices and acid were meant to stay in the stomach. The stomach was built to cope with those corrosive liquids. The esophagus is not protected from digestive juices. When they squirt up into the esophagus, heartburn results. The backup of digestive juices is GERD.
In a few heartburn patients, the lining of the esophagus undergoes a transformation that makes the esophagus’s features resemble those of the lower parts of the digestive tract. That transformation constitutes a Barrett’s esophagus. Barrett’s esophagus can be a prelude to cancer. But don’t worry, if caught early the condition is treatable and your condition should be carefully monitored.
Control of heartburn with medicine eliminates heartburn pain. But it doesn’t cause Barrett’s esophagus to revert back to normal. Scope examinations of the esophagus must be scheduled at regular intervals to detect cancerous changes. If the changes are slight, then yearly exams will suffice. If they are great, then exams may be scheduled for every three to six months.
Factors which increase your risk for Barrett’s esophagus include family history (your odds of being diagnosed with Barrett’s esophagus increase if you have a family member who has been diagnosed with this condition), being male (men are far more likely to develop Barrett’s esophagus), being white (white people have a greater risk for the disease than do people of other races), age (Barrett’s esophagus can occur at any age, but it’s more common among people age 50 and older), chronic heartburn and acid reflux (having GERD that doesn’t get better with medications like proton pump inhibitors or having GERD that requires regular medicines can increase your risk for Barrett’s esophagus), current and past smoking, and being overweight (body fat around your abdomen increases the risk).
To diagnose Barrett’s esophagus, an endoscopy will be performed by your doctor. A lighted tube with a camera at the end (endoscope) is passed down your throat to check for signs of changing esophagus tissue. Your doctor will remove some tissue to biopsy. The biopsied tissue can be examined to determine the degree of change.
Bear in mind, if GERD can be prevented, so can Barrett’s esophagus. You treat the esophagus problem by eliminating the stomach disturbance, the excess acid production and reflux. That calls for neutralizing antacids or medicines to lower acid production. The therapy does not reverse the problem, but it does keep it from worsening.
There are many medicines that slow down stomach acid production, so heartburn, GERD, and Barrett’s esophagus can be nipped in the bud. The names of some of those medicines are: Tagamet, Zantac, Pepcid, Axid, Prilosec, Prevacid, and Nexium.
Treatment for Barrett’s esophagus depends on the extent of abnormal cell growth in your esophagus and your overall health. For no dysplasia, your doctor may recommend periodic endoscopy to monitor the cells in your esophagus and treatment for GERD.
Low grade dysplasia means the early stages of precancerous changes. For low-grade dysplasia, your doctor may recommend another endoscopy in six months with follow-up endoscopies every six to 12 months. Some recommended procedures for low grade dysplasia include endoscopic resection (which uses an endoscope to remove damaged cells to aid in finding dysplasia and cancer), radiofrequency ablation (which uses heat to remove abnormal esophagus tissue), and cryotherapy (which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus).
High grade dysplasia is thought of as a precursor to esophageal cancer. Your doctor may recommend endoscopic resection, radiofrequency ablation or cryotherapy. Another option is surgery where the damaged part of your esophagus is removed and attached to the remaining portion of your stomach.
Please note that there can be a possible reoccurrence of Barrett’s esophagus after treatment. Talk to your doctor about how often you need follow-up testing. If you undergo treatment other than surgery to remove abnormal esophageal tissue, your doctor may suggest lifelong medication to decrease acid and help your esophagus heal.
There are some simple self-help strategies you can try. Maintain a healthy weight. Avoid eating foods that might trigger heartburn like chocolate, alcohol, coffee and mint. Stop smoking. Elevate the head of your bed. Talk to your doctor to find out other lifestyle changes may benefit you and alleviate your condition.
