Barrett’s Esophagus, caused by long-term exposure to stomach acid, makes the lining of the esophagus look more like the lining of the small intestine. It is most closely related to years of GERD, gastroesophageal reflux, when weakened muscles at the base of the esophagus allow food and acid back up into the esophagus.
Our Digestive Health Center experts at Hartford Hospital monitor this condition closely because it can lead to cancer.
While the stomach is well equipped to handle acid, the esophagus is not. Over time, acid reflux creates a film on the lining of the esophagus, leading first to Barrett’s and then to esophageal cancer if left untreated. Esophageal cancer associated with Barrett's has increased by over 500 percent in the past few decades.
Obesity, poor diet, alcohol use and chronic reflux may all contribute to the development of Barrett’s esophagus and esophageal cancer. Around 15 percent of people with acid reflux have Barrett’s and people with a family history of esophageal cancer are at a higher risk. Symptoms include persistent heartburn, trouble swallowing, chronic cough, chest pain and more.
Barrett’s esophagus is diagnosed by a minimally invasive procedure called an endoscopy.
Experts in Surgical Treatment of Barrett’s Esophagus
Where those with Barret’s esophagus at high risk of developing esophageal cancer once could choose only a single, dramatic treatment – removal of the esophagus – several types of less-invasive procedures using a medical device called an endoscope are now available. Digestive Health Center doctors are considered leading experts in these techniques.
Levels of Barrett’s Esophagus
Non-dysplastic: No evidence of abnormal cells. (Risk of cancer is less than 1 in 200 per year.)
Low-grade dysplasia: Some precancerous changes in cells.
High-grade dysplasia: The last stage of abnormal development in cells before they change into esophageal cancer.
Screenings & Tests / Treatments
Endoscopy: This device, a flexible tube with an attached camera, can be used to examine the esophagus and, with additional attachments, take a tissue sample (biopsy) or perform a procedure.
Capsule Endoscopy: The patient swallows a tiny video capsule that transmits images as it passes through the digestive tract.
24-Hour pH Testing: A small tube with a pH sensor inserted through the nose measures the amount of acid that flows back from the stomach into the esophagus.
Bravo Testing: A Bravo capsule inserted in mouth and down into the esophagus using an endoscope is attached to a wall of the esophagus, where it measures acid levels for 48 to 96 hours.
Barium Esophagram / Barium Swallow: Barium sulfate, a metallic compound, shows up on X-rays so your doctor can inspect your esophagus and back of the mouth or throat (pharynx). You must first drink a barium solution.
Esophageal Manometry: The strength of your esophageal muscles is assessed by a flexible tube inserted into your esophagus.
Radiofrequency Aablation: Diseased tissue is destroyed using heat energy from a device attached to an endoscope.
Endoscopic Mucosal Resection (EMR): Precancerous and early-stage cancer growths are removed using an endoscope.
Endoscopic Submucosal Dissection (ESD): This method achieves what was once possible only with open surgery – removing growths by separating the intestinal lining from the muscle wall.