There’s more at risk to letting your gastroesophageal reflux disease (GERD) go unchecked than dealing with bouts of acid indigestion and heartburn after meals — serious cases can lead to a more concerning condition called Barrett’s Esophagus.
Long-term exposure to acid from the stomach can leave tissue lining the esophagus looking more like the inside of the small intestine. That’s not all. Specialists should monitor Barrett’s Esophagus because it can progress to a form of cancer that has no symptoms of its own. The disease progression is common, with cases of Barrett’s-associated esophageal cancer jumping more than 500% in the last few decades.
Symptoms & Diagnosis
Because Barrett’s Esophagus is an extension of GERD, it is linked to the same causes, mainly increased pressure on the abdomen due to obesity or hiatal hernia, certain foods and drinks, and specific types of medication.
In addition to regular bouts of heartburn, Barrett’s Esophagus can cause the following symptoms:
- Chest pain
- Sour taste in the mouth
- Belching
- Trouble swallowing
- Asthma, wheezing or shortness of breath
- Feeling like you have a lump in your throat
- Chronic cough
- Pneumonia
- Abdominal pain
- Bad breath
- Tooth erosion
- Irregular sleep
- Laryngitis
To confirm you have Barrett’s Esophagus, your specialist will send you for one or more tests. Most are the same as tests for GERD, including:
- Acid (pH) probe test – we place a monitor attached to a thin tube through your nose and into the esophagus. Attached to a small computer you wear on a strap or around the waist, the monitor tells us when stomach acid regurgitates and for how long. We can also get this information by placing a capsule in your esophagus during an endoscopy. The capsule passes in a bowel movement in a few days.
- Bravo testing – we will use an endoscope to attach a special capsule to the inside wall of the esophagus to measure the acid levels for up to 96 hours. It will pass naturally.
- Endoscopy (EGD) - a minimally invasive procedure in which a small telescopic camera is sent through the mouth into the esophagus and stomach to take images and biopsies if needed. We are looking for signs of inflammation, infection or damage. We can also order a capsule endoscopy in which you swallow a tiny video capsule that sends images as it passes through your digestive tract.
- Manometry – measures the strength and muscle coordination of your esophagus when you swallow.
- Upper GI X-Ray – with barium and a special X-ray machine called a fluoroscope, we take images of the esophagus, small intestine and stomach.
The testing will also help determine your level of disease. Levels are:
- Non-dysplastic – there is no evidence of abnormal cells. The risk of cancer is less than 1 in 200 patients a year.
- Low-grade dysplasia – there are some precancerous changes in your esophagus cells.
- High-grade dysplasia – the disease is at the last stage of abnormal cell development before changing into cancer.
Treatment Options
Treatment for Barrett’s Esophagus has advanced in the last few years and members of our team are considered leading experts in the new techniques. At one point, only surgical removal of the esophagus could help, but newer treatments are much less invasive.
The newer techniques include:
- Endoscopic mucosal resection (EMR) – using an endoscope, the specialist removes precancerous and early-stage cancer growths from the esophagus.
- Endoscopic submucosal dissection (ESD) – the surgeon will remove growths by separating the intestinal lining from the muscle wall.
- Radiofrequency ablation – heat energy delivered from a device attached to an endoscope and inserted into the esophagus destroys diseased tissue.
Living with the Condition
As with GERD, we always suggest simple changes to your diet and lifestyle to minimize the impact Barrett’s Esophagus has on your day-to-day life. Our team is here to help you address habits that may trigger related symptoms.
Our suggestions include:
- Quit smoking. Smokers have a 500% greater chance of developing esophageal cancer.
- Avoid trigger foods. Common culprits are citrus, spicy and fried foods.
- Maintain a healthy weight.
- Cut down on alcohol.
- Eat smaller meals. Leaving your stomach less full means it produces less stomach acid to process the food.
- Eat slowly. It takes up to 20 minutes for the brain to know there is food in your stomach that needs digesting. Give your brain time to catch up.
- Don’t lie down after eating. Gravity will help your body digest.
In addition, we urge you to keep regular appointments with your specialist to be monitored for disease progression.