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Barrett's esophagus

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Screening and diagnosis

Barrett's esophagus is a complication of long term acid reflux disease. Barrett's esophagus is, the link between Barrett's esophagus and acid reflux disease, and the link to esophageal cancer.

Common heartburn isn't always just an annoying condition that's quickly remedied by an over-the-counter antacid. It can also be symptomatic of gastroesophageal reflux disease (GERD), which is the chronic regurgitation of acid from your stomach into your lower esophagus. And, long-term GERD can sometimes lead to Barrett's esophagus, a condition in which the color and composition of the cells lining your lower esophagus change because of repeated exposure to stomach acid. Having Barrett's esophagus increases your risk of developing esophageal cancer.

Barrett's esophagus usually develops from gastroesophageal reflux disease (GERD). Heartburn and acid reflux are the most common symptoms of GERD and result from stomach contents washing into the esophagus.

The ring of muscle at the junction of the esophagus and stomach (sphincter) normally traps acid in your stomach by clamping shut. GERD usually results from a weakened sphincter, and it can be aggravated by a protrusion of the upper stomach, where the esophagus passes through the diaphragm (hiatal hernia).

Left untreated, GERD can lead to more serious complications such as severe heartburn (with esophagitis) — the chest pain can be intense enough to resemble a heart attack — stricture, bleeding, Barrett's esophagus and even esophageal cancer.

Diagnosing Barrett's esophagus is difficult because it often doesn't exhibit specific symptoms. Experiencing the acid reflux of GERD may be the best indication that you either have Barrett's esophagus or may be at risk to acquire the disease.

If you have severe acid reflux, your doctor may discover Barrett's esophagus by examining your esophagus through endoscopy. Endoscopy involves inserting a lighted, flexible tube (endoscope) with a camera on its tip through your mouth and into your esophagus and stomach. Usually, you'll receive a local anesthetic, and you may be sedated for this procedure.

The procedure allows your doctor to search for abnormalities such as precancerous cell changes (dysplasia) or an abnormal junction between your stomach and esophagus. In a healthy esophagus, the stomach-esophagus mucosal junction is at the lower end of the esophagus. In Barrett's esophagus, this junction is displaced upward. If Barrett's esophagus is suspected, your doctor also looks for evidence of cancer.

During endoscopy, your doctor may remove tissue samples (biopsies) of potentially abnormal areas to be examined under a microscope. If specimens reveal intestinal goblet-shaped cells, your doctor may make a diagnosis of Barrett's esophagus.


Having Barrett's esophagus increases your risk of developing esophageal cancer. The earlier that metaplasia — the telltale changing of the color of the tissue that lines the lower esophagus from its normal pink to a salmon color — is detected, the better.

Barrett's esophagus may develop precancerous changes (dysplasia) in grades ranging from none to mild but still significant changes (low-grade), to serious changes (high-grade), and finally to invasive cancer. When high-grade dysplasia is detected, cancer often is already present. Cancer can spread from the esophagus to nearby lymph nodes and to other parts of your body.


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Last Modified : 03/14/08 07:03 PM