Barrett’s Esophagus or Barrett Syndrome: Symptoms, Diagnosis, Treatment, Lifestyle Changes

Barrett’s esophagus is a potentially serious complication of gastroesophageal reflux disease or GERD. If an individual has Barrett’s esophagus, then one’s normal lining of tissue in the esophagus changes to a tissue lining which is similar to that in the intestine. In normal population, about 15% of people suffering from GERD go on to develop Barrett’s esophagus. There are no specific symptoms in Barrett’s esophagus but if an individual has Barrett’s esophagus then that person may have symptoms which can be related to GERD. Barrett’s esophagus, however, increases the risk of a person developing esophageal adenocarcinoma which is a potentially fatal cancer of the esophagus. Although patients with Barrett’s esophagus are at increased risk of developing cancer of the esophagus but the actual instances are still pretty less, in that only about 1% of people with Barrett’s esophagus go on to develop cancer. Having said that, if a person has been diagnosed with Barrett’s esophagus, then it becomes necessary for him or her to have frequent and routine esophageal examinations since doing it can help a physician diagnose precancerous cells early and treatment gets a lot easier.

There are certain facts that a person should know about Barrett’s Esophagus or Barrett Syndrome, some of which are given below:

• There is only a very small part of population, less than 10%, with GERD who go on to develop Barrett’s esophagus, which means that not everyone with GERD develop Barrett’s esophagus and vice versa.
• Even if a person is diagnosed with Barrett’s esophagus, the chances of one getting esophageal cancer is very less, not more than 1%.
• The diagnosis of Barrett’s esophagus should not be a reason for major concern for a person. It is true that Barrett’s esophagus can lead to precancerous changes increasing risk for cancer in some people but the percentage of that is extremely low.

Is There Any Distinct Relationship between GERD And Barrett’s Esophagus or Barrett Syndrome?

Individuals who have gastroesophageal reflux disease or GERD have symptoms like heartburn, a burning feeling at the back of throat, chronic cough, inflammation of larynx, and nausea.

The lower part of the esophagus contains a ring of muscles called the esophageal sphincter, which protects the food present in the stomach from going back into the esophagus. In case of GERD, the contents of the stomach flow back into the esophagus. This is called as reflux. It is shown that majority of the people who have reflux do not develop Barrett’s esophagus but people who have reflux frequently the cells in the esophagus get replaced by cells which are apparently similar to the cells present in the intestine and such people go on to develop Barrett’s esophagus.

Is Gerd a Precursor for Barrett’s Esophagus or Barrett Syndrome?

The answer for this is a straight no. Not everyone with GERD go on to develop Barrett’s esophagus and vice versa, but chronic long term GERD is definitely a major risk factor for development of Barrett’s esophagus. Another major risk factor for development of Barrett’s esophagus is current or remote history of smoking.

Barrett’s esophagus does not have its own set of symptoms. Individuals suffering from Barrett’s esophagus experience symptoms of GERD like heartburn, nausea, regurgitation etc. Generally, people with Barrett’s esophagus will have more severe symptoms of GERD than a normal individual, although it is not a thumb rule that everyone with Barrett’s esophagus will definitely have symptoms of GERD. There have been cases where Barrett’s esophagus has been incidentally diagnosed even though that individual has had very little, if any, symptoms of GERD.

Sometimes, the regurgitated fluid may infiltrate the lungs or larynx leading to what is termed as “extra-esophageal” symptoms of GERD. Some Of These Symptoms Are As Follows:

• New onset adult asthma
• Frequent bronchitis
• Chronic cough
• Sore throat
• Hoarseness

Since there are no clear cut symptoms to identify Barrett’s esophagus, it can only be done by visualizing the lining of the esophagus via an upper endoscopy and biopsy. The American Gastroenterological Association recommends screening of people who have major risk factors for Barrett’s esophagus. These risk factors include:

• People above the age of 50.
• Male sex.
• People with a history of hiatal hernia.
• People with longstanding history of GERD.
• Obesity.

To do an endoscopy, the gastroenterologist will insert a flexible tube with a camera attached to it into the esophagus and will visualize the esophagus. The presence of Barrett’s esophagus is caught on camera. The physician may also take out a piece of tissue as a sample to perform biopsy on it to look for precancerous cells. A followup endoscopy may be recommended in case Barrett’s esophagus is confirmed. If there is presence of precancerous cells on biopsy, then the physician may discuss treatment and surveillance options.

The primary goal of treatment for Barrett’s esophagus is concentrated on slowing down its development and that can be done by medications and lifestyle modifications.

• Avoiding fatty and spicy foods, abundant caffeine intake which tends to exacerbate reflux.
• Avoidance of alcohol and tobacco.
• Maintaining ideal body weight as being overweight increases risk of reflux.
• While sleeping keep head of the bed elevated to prevent reflux.

• Proton Pump Inhibitors which cuts down the production of stomach acid
• Antacids for neutralization of stomach acid
• H2 blockers which cuts down the release of stomach acid
• Medications which help in speeding up movement of food from stomach to intestines.