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When all is well, your esophagus – which carries food from your throat to your stomach – has a smooth, pale pink lining of cells. But with a condition called Barrett’s esophagus, this lining can become damaged and replaced by abnormal cells that resemble tissue found in the small intestine.

These abnormal cells may not cause you problems, but they have a higher chance of becoming cancerous than normal tissue.

Gastroesophageal reflux disease (GERD) is a leading cause of Barrett’s esophagus.

When you have GERD, the acidic contents of your stomach back up into your esophagus. This action is normally prevented by a one-way valve, called the lower esophageal sphincter. But if the valve weakens, reflux and heartburn can result, causing a burning sensation, burping, or sour-tasting fluid in your mouth.

Your stomach lining naturally withstands the damaging effects of stomach acid. But the lining of your esophagus does not.

Who Is Likely To Get Barrett’s Esophagus?

Barrett’s esophagus affects a small percentage of the population – about 1.6 to 6.8 percent. Men are twice as likely as women to develop the condition, especially Caucasian men. The average age at diagnosis is 55.

Frequent bouts of acid reflux may change the lining of your esophagus over time – and about 10 to 15 percent of people with GERD develop Barrett’s esophagus.

Other contributing factors to Barrett’s esophagus include smoking and obesity with high levels of belly fat. Some experts also believe that genetics play a role.

Your stomach lining naturally withstands the damaging effects of stomach acid. But the lining of your esophagus does not.

The Risk Of Cancer With Barrett’s Esophagus

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If you have Barrett’s esophagus, your risk of developing cancer is low – about one in 200. You are encouraged, however, to have routine endoscopy examinations to study the tissue in your esophagus. During an upper endoscopy procedure, you’ll be put under light sedation while your doctor threads a slender tube down your throat and esophagus to examine the lining and take a tissue sample. 

Sometimes, a precancerous condition called dysplasia occurs. Dysplasia is an abnormal growth pattern of cells and can be present in a small or large number of cells.

If you have dysplasia, your doctor may recommend more frequent upper endoscopy exams or endoscopic procedures to destroy the precancerous cells.

Who Needs Treatment And What Are the Options?

If you are experiencing symptoms such as difficulty swallowing; unexplained weight loss; black, tarry stool; or vomiting, see your doctor for an evaluation. This is especially true for men who are over age 50, white, and have had GERD symptoms for 10 years or more.

Gastroenterologists and other medical providers typically treat the symptoms of GERD to stop the progression of Barrett’s esophagus. Common medications are antacids, histamine receptor antagonists, and proton pump inhibitors (such as Nexium, Prevacid, Prilosec, and Protonix).

Other treatments include:

  • Regular endoscopy exams. Your doctor may recommend annual (or more frequent) endoscopy exams to monitor precancerous tissue.
  • Radiofrequency ablation. This involves application of heat from radio waves, through an endoscope, to kill abnormal cells and allow normal cells to replace them.
  • Photodynamic therapy. A light-activated chemical, called porfimer, is injected into a vein in your arm 24 to 72 hours before this treatment. During the procedure, your doctor will use an endoscope with a laser attached to kill precancerous cells in your esophagus.
  • Surgery. If you have high-grade dysplasia, the stage that develops just before esophageal cancer, a surgeon may remove the -+abnormal part of the esophagus. This procedure is called an esophagectomy.

The best ways to prevent Barrett’s esophagus are to manage GERD, maintain a healthy weight, and don’t smoke.