Barrett's Esophagus

Overview

Symptoms

With Barrett's esophagus, you may not have any signs or symptoms. Those who do may have:

• Frequent heartburn
• Difficulty swallowing food
• Chest pain (uncommon)

If you've had trouble with heartburn and acid reflux for more than five years or experience any of the following symptoms, talk to your physician immediately:

• Vomiting red blood or blood that looks like coffee ground
• Black, tarry or bloody stools

Barrett's Esophagus Cause

Physicians believe that chronic reflux or gastro-esophageal reflux disease (GERD) may cause Barrett's esophagus.

Risk Factors for Barrett's Esophagus

Between 5 and 10 percent of people with GERD develop Barrett’s esophagus. Obesity and smoking pose risks as well. Barrett's esophagus most commonly occurs in overweight, Caucasian males over the age of 50 with chronic GERD symptoms. Considered pre-cancerous, in some cases, dysplasia occurs (abnormal development at a microscopic level) with Barrett's esophagus.

Diagnosis

Physicians can have difficulty diagnosing Barrett's esophagus. Indiana University Health physicians will provide advanced testing to evaluate and treat your GERD, and assist you with swallowing difficulties.

IU Health physicians have expertise in diagnostic and therapeutic endoscopy. This makes us uniquely positioned to deliver specialized care for you, even if you have irregularities.

Treatment

Controlling GERD is essential to prevent and manage Barrett’s esophagus. Our affiliation with the IU School of Medicine and the Division of Gastroenterology and Hepatology keeps us on the leading edge of advancements for diagnosing and treating Barrett’s esophagus. By participating in research and clinical trials, we create and learn the best ways to treat your symptoms.

IU Health physicians have extensive experience with treatments that will benefit you with excellent short- and long-term results. Your physicians’ goal will be to remove Barrett’s esophagus and abnormal cells, and regularly monitor your condition to maintain your health. IU Health has one of the few centers in Indiana to offer specific treatments for Barrett’s esophagus with high-grade dysplasia and other unusual features.

• Medicines
• Endoscopic mucosal resection (EMR). Your physicians have expertise in endoscopy allowing them to take larger, deeper biopsies and resections of abnormal precancerous esophagus cells. Endoscopic ultrasound (EUS) may precede EMRs for cancer removal to ensure the cancer cells only exist in the top layer of your esophagus lining. More than half the patients referred to IU Health for Barrett’s esophagus undergo EMR for treatment of high-grade dysplasia and irregularities.
• Radiofrequency ablation (RFA). This procedure uses radio waves delivered by endoscope to heat and kill Barrett’s and dysplastic cells in your esophagus. RFA is a highly successful treatment for getting rid of abnormal cells in the first, or mucosal, layer of your esophagus lining.
• Cryotherapy. This treatment freezes high-grade dysplasia cells with carbon dioxide and liquid nitrogen. An endoscope applies the therapy.
• Argon plasma coagulation (APC). This treatment uses thermal therapy to cauterize diseased tissues in the esophagus to stop bleeding. An endoscope delivers this treatment--often applied after polyp removal or resection.
• Dilation. If your esophagus has narrowed by thickened and hardened tissue, your physician may stretch it to widen the space.
• Surgery. Your surgeon may perform surgery to remove a large part of your affected esophagus. Your surgeon will then rebuild and reattach your esophagus to your stomach.
• Follow-up. When you have dysplasia, in addition to treatment, we monitor your esophagus every six to 12 months. This allows us to take additional biopsies to check your esophagus cells and track any dysplasia. There is a 30 percent recurrence rate for Barrett’s esophagus, even if earlier treatments result in a complete response.