What is Barrett’s Esophagus?

Heartburn that is severe or that occurs frequently over a long period of time can be harmful. Prolonged Heartburn is known as Gastroesophageal Reflux Disease (GERD).

If GERD is untreated, complications may arise from the constant acid irritation to the lining of the esophagus. 

About 1 in 10 patients with GERD are found to have a condition called Barrett’s esophagus.

Barrett’s esophagus is a condition that may develop as a result of chronic GERD. Barrett’s tissue growing in the esophagus appears to be the body’s defense against continued stomach acid irritation. Yet, this tissue does not belong in the esophagus, and for some patients, it increases the risk of developing cancer.


Normally, there is an area at the end of the esophagus that marks the border between the cells of the esophagus and those of the stomach. Barrett’s esophagus is the abnormal growth of intestinal-type cells above this border, into the esophagus.

The cells lining the esophagus differ from those lining the stomach or intestines, mainly because they have different functions. The cells also have a distinctly different appearance, so it is usually easy for a physician to tell them apart when examining the esophagus and stomach. These differences are how Barrett’s is problematic.

Since the cells lining the stomach are protected from contact with acid, abnormal cell growth into the esophagus may actually be a defense mechanism. It may protect the normal tissue in the esophagus against further damage by GERD. This may explain why the symptoms of GERD seem to lessen in some patients with Barrett’s esophagus.


In time, the Barrett’s cells may develop abnormal changes known as dysplasia. Over a period of perhaps two to five years, the dysplasia may then progress to low grade, then to high grade dysplasia, and finally to cancer.

Fortunately, cancer happens only in about 1-5% of patients with Barrett’s esophagus.

Cause and Symptoms

In some instances, Barrett’s esophagus appears to be congenital (present at birth). However, current evidence is strong that in most instances, it develops as a result of longstanding GERD.

Patients with Barrett’s usually have symptoms similar to those produced by chronic GERD, such as heartburn and reflux of stomach acid into the mouth. Some Barrett’s patients may also suffer from other complications of GERD, such as esophageal peptic ulcers and stricture — narrowing of the esophagus that comes from scarring. These facts are why it is important for patients with these symptoms to see their physicians regularly.

The Lower Esophageal Sphincter (LES) is a strong muscular ring at the lower end of the esophagus at the stomach. The LES should remain tightly closed, except to allow food and liquid to pass into the stomach. Heartburn occurs when the LES opens at the wrong time. Almost everyone has this occasionally, and it is nothing to be concerned about.

It can be serious and may lead to cancer of the esophagus.

On Going Monitoring

Currently, there are no medications to reverse Barrett’s esophagus. However, it appears that treating the underlying GERD may slow the progress of the disease and prevent complications.

A diagnosis of Barrett’s esophagus requires regular monitoring by a physician. While it is thought that controlling GERD reduces the risk of developing cancer, this has not yet been definitely proven.

Therefore, the physician must perform regular endoscopy exams and biopsies to look for dysplasia. Just how often these exams are repeated depends on how far the disease has advanced. If cancer is found, surgery to remove the lower esophagus is usually necessary. Physicians often recommend this procedure when high grade dysplasia is present, so as to prevent the cancer that is likely to occur.

Regular monitoring by your physician is necessary