Barrett’s Esophagus

Last Updated October 2020 | This article was created by familydoctor.org editorial staff and reviewed by Leisa Bailey, MD

What is Barrett’s esophagus?

Barrett’s esophagus is a condition that affects your esophagus. That’s the tube that food travels down when you eat. It connects your throat to your stomach.

A section of muscles separates your esophagus from your stomach. Its job is to keep acid from your stomach from coming back into your esophagus. If those muscles don’t close the right way, acid goes back into your esophagus. This is known as gastroesophageal reflux disease (GERD). Over time, this acid can damage the lining of your esophagus. It also can make the tiny cells in your esophagus change. If this happens, it’s called Barrett’s esophagus. Although uncommon, Barrett’s esophagus can lead to cancer.

Symptoms of Barrett’s esophagus

Barrett’s esophagus doesn’t cause symptoms. Instead, it’s the symptoms of GERD that typically lead your doctor to discovering you have it. That’s why it’s important to tell your doctor if you have GERD 3 or more times a week. Symptoms of GERD include:

  • Heartburn.
  • A cough.
  • Trouble swallowing.
  • Pain when you swallow.
  • Sudden weight loss.
  • Blood in your vomit or bowel movements.
  • Bowel movements that look like black tar.

What causes Barrett’s esophagus?

Repeat damage from stomach acid causes Barrett’s esophagus. People who have GERD have a higher risk of getting it. Also, people who are smokers, obese, or older than 50 years of age are at greater risk. Barrett’s esophagus is more common in white and Hispanic men.

How is Barrett’s esophagus diagnosed?

If you have GERD, your doctor likely will monitor you for Barrett’s esophagus. People who have severe GERD may need an endoscopy. This is an outpatient procedure to look at your esophagus and check for damage. For this test, you are given medicine to relax. Then the doctor inserts a thin, flexible tube in your throat. He or she may take a tissue sample to biopsy. This can detect abnormal cells, which can lead to cancer.

If the test shows normal cells, your doctor will recommend a follow-up endoscopy every 3 to 5 years. If the test shows abnormal cells, you may need an endoscopy once a year.

One of the complications of Barrett’s esophagus is esophageal strictures (when the esophagus becomes very narrow). One symptom of this is difficulty swallowing. When the doctor performs an endoscopy for that symptom, they often will find and diagnose Barrett’s esophagus.

Can Barrett’s esophagus be prevented or avoided?

You can help prevent Barrett’s esophagus. Your doctor may recommend lifestyle changes, such as:

  • Quitting smoking, if you smoke.
  • Being more active.
  • Losing weight.

Avoiding foods that trigger heartburn. Common ones are coffee, chocolate, peppermint, and alcohol. Greasy, spicy, or tomato-based foods can cause heartburn as well.

Barrett’s esophagus treatment

The main form of treatment is a group of medicines called proton pump inhibitors (PPIs). These help relieve pain and reduce the amount of acid in your stomach. They keep Barrett’s esophagus from getting worse. In severe cases, surgery may be done to stop reflux and keep stomach acid out of the esophagus.

Living with Barrett’s esophagus

There is no cure for Barrett’s esophagus. But treating the GERD symptoms may reduce further damage. Follow your doctor’s orders to get regular endoscopies, if needed. This can detect abnormal or precancerous cells.

Questions to ask your doctor

  • If I have GERD, will I eventually have Barrett’s esophagus?
  • How long do I need to take medicine to treat Barrett’s esophagus?
  • What are the side effects of treatment?
  • Are there lifestyle changes I can make to help ease my symptoms?
  • If I have Barrett’s esophagus, what is my risk of cancer?