Barrett's Esophagus
Also known as: Barrett esophagus, Barrett's oesophagus, Columnar-lined esophagus
Barrett's esophagus is a change in the lining of the lower esophagus, the tube that carries food from the mouth to the stomach. After years of exposure to stomach acid from chronic reflux, the normal flat cells are replaced by cells that resemble those of the intestine. This change does not cause symptoms by itself and is usually discovered during an endoscopy done for heartburn. Barrett's esophagus matters because it slightly raises the risk of esophageal adenocarcinoma, a type of cancer. The overall risk for any individual remains low, and regular surveillance endoscopy can catch precancerous changes early, when they can be treated effectively without major surgery.
At a Glance
- Common symptoms
- No symptoms from the Barrett's changes themselves, Long-standing heartburn or acid reflux, often for many years, Regurgitation of food or sour liquid
- Main treatments
- Long-term proton pump inhibitor medication to control acid reflux and reduce ongoing injury, Regular surveillance endoscopy with biopsies to detect dysplasia early, Endoscopic treatments such as radiofrequency ablation or endoscopic resection to remove areas of dysplasia or early cancer
- Category
- Digestive · Found in a minority of people with chronic reflux; more common in older men and people with obesity
- See a doctor if
- Heartburn or reflux occurring several times a week for years, particularly if you are male, over 50, overweight, or a smoker
Symptoms
Causes
- Chronic gastroesophageal reflux disease (GERD) exposing the esophagus to stomach acid and bile
- Repeated injury and repair of the esophageal lining leading to a change in cell type
- Hiatal hernia, which makes reflux more likely
- Genetic susceptibility, as the condition sometimes clusters in families
Risk Factors
- Chronic reflux symptoms for five years or more
- Male sex and age over 50
- White ethnicity
- Obesity, particularly fat around the abdomen
- Current or past smoking
- A family history of Barrett's esophagus or esophageal cancer
Diagnosis
- Upper endoscopy, in which a thin camera is passed down the throat to inspect the esophageal lining
- Biopsies taken from the changed area to confirm the diagnosis under a microscope
- Grading of any dysplasia (precancerous cell changes) as none, low grade, or high grade
- Surveillance endoscopy at intervals set by the length of the segment and the biopsy findings
- Newer options such as swallowable capsule-sponge tests are being used in some centers for screening
Treatment
- Long-term proton pump inhibitor medication to control acid reflux and reduce ongoing injury
- Regular surveillance endoscopy with biopsies to detect dysplasia early
- Endoscopic treatments such as radiofrequency ablation or endoscopic resection to remove areas of dysplasia or early cancer
- Anti-reflux surgery (fundoplication) for some people with severe reflux not controlled by medication
- Esophagectomy (surgical removal of part of the esophagus) reserved for advanced cancer
- Supportive: weight loss, smaller meals, not eating within three hours of lying down, and raising the head of the bed to reduce reflux
- Supportive: stopping smoking and limiting alcohol, both of which increase cancer risk
Prevention
- Treat persistent heartburn rather than ignoring it for years
- Maintain a healthy weight, especially around the waist
- Do not smoke
- Avoid large late-night meals and foods that trigger your reflux
- Ask your doctor about an endoscopy if you have had reflux for many years and other risk factors
- Keep to the surveillance schedule once Barrett's has been diagnosed
When to See a Doctor
- Heartburn or reflux occurring several times a week for years, particularly if you are male, over 50, overweight, or a smoker
- Difficulty swallowing or food sticking in the chest
- Unintended weight loss or persistent vomiting
- Vomiting blood or passing black stools (emergency)
- Reflux symptoms that need daily medication to control
Frequently Asked Questions
Related Conditions
Have questions about Barrett's Esophagus?
Ask Mother Nature AI for personalized, evidence-based guidance.
Ask about Barrett's EsophagusMedical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.