Barrett's Esophagus

Barrett's Metaplasia or Barrett's Esophagus refers to patients with chronic reflux esophagitis in whom the normal squamous esophageal mucosa (lining) is replaced with intestinal or gastric (stomach) tissue. This occurs presumably as a potentially protective response to acid exposure since esophageal tissue is not "made to handle acid.” It is estimated that Barrett's develops in 10% of patients with chronic reflux/heartburn.

Complications associated with this disorder include esophagitis (inflammation of the esophagus), esophageal ulcerations, stricture (narrowing of the esophagus due to ulceration and scarring), and adenocarcinoma of the esophagus. The incidence of cancer in patients with Barrett's is between one and 200-400 patients.

The precancerous stage, dysplasia, can be found on biopsies of the areas involved with Barrett's. Periodic biopsies are performed during an endoscopy (EGD). If no dysplasia or cancer is found, the EGD and biopsies are usually repeated every 1-3 years. Therefore, cancer associated with Barrett's is a potentially preventable disease by finding the cancerous precursor (dysplasia) and treating it appropriately. Surgical resection is recommended in cases of severe dysplasia or cancer. Dysplasia is defined as abnormal and potentially precancerous cells and is graded according to the degrees of abnormality (i.e. mild, moderate, and severe).

Screening for Barrett's esophagus can be done in patients with chronic heartburn - these are the patients at risk for Barrett's and potentially cancer. Screening with endoscopy (EGD) is usually performed every 1-3 years.

Barrett's Esophagus

Barrett's Esophagitis

Barrett's with Ulceration