Barrett’s esophagus is a condition that can develop in patients who have chronic gastroesophageal reflux disease (GERD) or esophagitis (inflammation of the esophagus). Muscles connecting the esophagus to the stomach work to keep food and fluids in the stomach from backing into the esophagus. When this fluid does back up, reflux, commonly known as heartburn, will occur. Some patients remain asymptomatic of heartburn or chest pain even in the presence of severe reflux disease. The lack of heartburn or chest pain does not mean you do not have reflux disease.
Prolonged exposure to reflux causes esophageal cells to change into cells that resemble those of the intestine. Over time, these changes can lead to the development of precancerous cells, which is referred to as high-grade dysplasia (HGD). It is important to know that most patients with Barrett’s esophagus do not develop HGD. However, it is crucial for patients with Barrett’s esophagus to be carefully monitored, since development of HGD significantly increases the risk of developing esophageal cancer. Approximately 45 percent of patients diagnosed with HGD have undiagnosed adenocarcinoma of the esophagus.
The Division of Thoracic Surgery at Brigham and Women’s Hospital (BWH) provides specialized services for Barrett’s esophagus, such as diagnostic endoscopy, photodynamic therapy with Photofrin™, endomucosal resection therapy (EMR), and other surgical options. Our board-certified surgeons are experts in the latest minimally invasive thoracic surgical techniques, including Nissen fundoplication and trans-oral therapies.
Factors contributing to an increased risk of developing Barrett’s esophagus include:
Many patients with Barrett’s esophagus experience no symptoms. Patients who do have symptoms may experience:
In addition to a careful physical examination, your thoracic surgeon will perform the following tests or procedures:
Currently, there is no cure for Barrett's esophagus. Treatment is aimed at preventing further damage to the esophagus by stopping acid reflux from the stomach. Treatment may include:
You will receive a thorough diagnostic evaluation and receive clinically proven treatment by a board-certified thoracic surgeon who specializes in Barrett’s esophagus. Careful monitoring and the involvement of an experienced thoracic surgeon are important to the successful outcome for patients with Barrett’s esophagus and HGD.
Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. If your thoracic surgeon discovers an underlying illness or concern, you will be referred to an appropriate BWH physician for an expert evaluation.
Visit the Dana-Farber/Brigham and Women’s Cancer Center for more information about esophageal cancer.
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