What are the other Names for this Condition? (Also known as/Synonyms)

• Barrett Esophagus
• CELLO (Columnar Epithelial-Lined Lower Esophagus)
• Columnar-Lined Esophagus (CLE)

What is Barrett’s Esophagus? (Definition/Background Information)

• Barrett’s Esophagus is a condition that results in the transformation of the normal esophageal lining (squamous epithelial lining) to the lining that is similar to the intestinal lining (columnar epithelial lining)
• It can occur in individuals of all ages, but is most common in elderly males, particularly of Caucasian descent
• The exact cause of Barrett’s Esophagus formation is unknown, though chronic heartburn, acid reflux, obesity, and smoking, are all known risk factors of the condition
• Gastroesophageal reflux disease (GERD) is believed to contribute to Barrett’s Esophagus development by causing damage to the esophagus
• An upper GI endoscopy and esophageal tissue biopsy can help diagnose Barrett’s Esophagus
• Treatment of Barrett’s Esophagus depends on the severity of the disease and the extent of dysplasia (abnormal cell proliferation) that is present. Most cases with low-grade dysplasia have a good prognosis
• However, in Barrett’s Esophagus with high-grade dysplasia, there is a chance that it could progress to esophageal cancer
• Preventative measures to reduce the likelihood of developing Barrett’s Esophagus can include diet and lifestyle changes and suitable treatment of GERD

Who gets Barrett’s Esophagus? (Age and Sex Distribution)

• Barrett’s Esophagus can affect individuals of all ages, but it is more common in older adults (over the age of 60 years)
• The disease is up to 3-4 times more common in males than in females
• People of Caucasian descent are ten times more likely to develop the condition than individuals of other races or ethnicities

What are the Risk Factors for Barrett’s Esophagus? (Predisposing Factors)

Risk factors of Barrett’s Esophagus may include:

• Chronic heartburn and acid reflux
• Males are more likely to develop the condition than females
• Older adults, especially over the age of 60 years, are at a higher risk
• Caucasians are at a much higher risk of developing Barrett’s Esophagus than people of other races and ethnicities
• General obesity and excess fat deposits around the abdomen increase one’s risk
• A history of smoking can also increase the likelihood of Barrett’s Esophagus development

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Barrett’s Esophagus? (Etiology)

The exact cause and mechanism of Barrett’s Esophagus development is currently unknown.

• Most individuals with Barrett’s Esophagus have a history of gastroesophageal reflux disease (GERD)
• GERD results in stomach contents washing back into the esophagus. When this occurs, the acidic contents can damage the esophageal tissue. Sometimes, as the esophagus attempts to heal itself, the cells can transform into the cell type associated with Barrett’s Esophagus (from the squamous epithelial lining to columnar epithelial lining)
• However, it has also been observed that some individuals with Barrett’s Esophagus have never experienced GERD, heartburn, or acid reflux

What are the Signs and Symptoms of Barrett’s Esophagus?

Frequently, Barrett’s Esophagus does not produce any unique signs or symptoms.

• As it is common in individuals with GERD, many individuals experience heartburn, regurgitation of food, and acid reflux
• Other symptoms can include difficulty swallowing, excessive belching, hoarse voice, sore throat, and shortness of breath
• Anemia (low blood count) can develop if the columnar lining of the esophagus becomes irritated and begins to bleed
• In rare cases, ulcer formation within the esophagus can also occur in individuals; this may cause some pain

How is Barrett’s Esophagus Diagnosed?

A diagnosis of Barrett’s Esophagus may involve:

• Complete evaluation of the individual’s medical history and a thorough physical examination. Evaluation of one’s medical history may help determine if there is the presence of a predisposing factor such as chronic heartburn, acid reflux, or obesity
• Upper gastrointestinal (GI) endoscopy can be used to diagnose Barrett’s Esophagus: In an upper GI endoscopy, an endoscope (a long flexible tube with an attached camera) is used to view the inside of the upper GI tract. The endoscope is directed down the esophagus and into the stomach and duodenum and may show if changes have occurred to the lining of the esophagus  
• An esophageal tissue biopsy can provide a definitive diagnosis for Barrett’s Esophagus: In this tissue biopsy, the physician removes a sample of the esophageal tissue using an endoscope. The tissue is sent to the laboratory for a histopathological examination. The pathologist examines the biopsy under a microscope. The pathologist arrives at a definitive diagnosis after a thorough evaluation of the clinical and microscopic findings, as well as by correlating the results of special studies on tissues (if required)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions in order to arrive at a definitive diagnosis.

What are the possible Complications of Barrett’s Esophagus?

• Complications associated with Barrett’s Esophagus depend on the severity of the disease
• While highly unlikely, individuals with this disorder are at an increased risk of developing esophageal cancer

How is Barrett’s Esophagus Treated?

Treatment options for Barrett’s Esophagus depend on the severity of the disease. A treatment plan is developed based on the degree of dysplasia (abnormal cell proliferation) found in the patient’s esophageal cells.

When low-grade dysplasia is noted, the treatments may include:

• Periodic endoscopy to monitor esophageal cells for possible progression into cancerous cells
• Treatment of GERD using medication and lifestyle changes
• Common medications can include antacids, histamine receptor antagonists, and proton pump inhibitors (all medicines control excess acidity in the stomach and esophagus)
• Lifestyle changes can involve adjustments to one’s diet to reduce consumption of fatty foods, decreased caffeine intake, reducing alcohol consumption, and stopping smoking

When high-grade dysplasia is noted, the treatments may include:

• Endoscopic resection, which involves using an endoscope to remove the diseased portion of the esophagus
• Radiofrequency ablation, where heat is used to remove the damaged esophageal cells and tissue
• Cryotherapy: The use of an endoscope to apply a cold liquid or gas to abnormal esophageal cells. The cells are then allowed to warm-up. This cycle of freezing and thawing the cells damages the abnormal cells
• Surgery can also be done to remove a portion of the esophagus that has been damaged

Regardless of what treatment is administered, follow-up care and regular screenings are important to ensure that Barrett’s Esophagus does not progress and cause further complications.

How can Barrett’s Esophagus be Prevented?

Preventive measures of Barrett’s Esophagus can include:

• Treatment of GERD to reduce damage to the esophagus
• Bringing about certain lifestyle changes such as diet adjustments to reduce fatty food and caffeine intake, reduction of alcohol intake, and cessation of smoking
• Early diagnosis of Barrett’s Esophagus is the best way to prevent this condition from progressing into esophageal cancer

What is the Prognosis of Barrett’s Esophagus? (Outcomes/Resolutions)

• The prognosis of Barrett’s Esophagus is usually good when low-grade dysplasia is present
• However, if Barrett’s Esophagus progresses to esophageal cancer, the prognosis is typically grim

Additional and Relevant Useful Information for Barrett’s Esophagus:

Please visit our Digestive Health Center for more physician-approved health information:

https://www.dovemed.com/healthy-living/digestive-center/