Barrett’s esophagus occurs when chronic acid exposure from GERD causes the normal squamous lining of the lower esophagus to be replaced with specialized intestinal-type cells (intestinal metaplasia). Most people with Barrett’s have ongoing reflux symptoms, but some have minimal or no heartburn.
While the overall risk of progressing to esophageal adenocarcinoma is low each year, it is higher than in the general population. For this reason, many patients benefit from regular endoscopic surveillance and aggressive reflux control. In certain cases with dysplasia, endoscopic ablation or resection may be recommended.
Barrett’s itself usually does not cause unique symptoms; most people experience symptoms of chronic GERD such as heartburn and regurgitation, or they may be found to have Barrett’s incidentally during endoscopy.
Call the office if you have Barrett’s esophagus and experience worsening reflux, new or progressive trouble swallowing, unexplained weight loss, or changes in your usual symptoms. These changes may prompt earlier evaluation.
Seek emergency care for vomiting blood, black or tarry stools, severe chest pain, or sudden difficulty swallowing or breathing. These can be signs of bleeding or other serious complications and should be evaluated urgently.
Barrett’s is diagnosed with upper endoscopy and biopsies that confirm intestinal metaplasia in the lower esophagus. After diagnosis, surveillance schedules are based on the presence and grade of dysplasia, along with individual risk factors.
Management focuses on controlling reflux, reducing cancer risk, and monitoring for progression. This includes acid suppression, lifestyle changes, and regular endoscopic surveillance. In patients with dysplasia, endoscopic ablation or resection can remove abnormal tissue and further reduce cancer risk.
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