Acid reflux occurs when acid backs up from the stomach into the esophagus. This causes symptoms such as chest pain or heartburn, stomach pain, or a dry cough. Chronic acid reflux is known as gastroesophageal reflux disease (GERD).
Symptoms of GERD are often overlooked as minor. However, chronic inflammation in your esophagus can lead to complications. One of the most serious complications is Barrett’s esophagus.
Barrett’s esophagus occurs when the tissue of the esophagus is replaced by tissue more similar to that of the intestinal lining. This change is called metaplasia. Metaplasia is a process where one type of cell is replaced with another. In the case of Barrett’s esophagus, esophageal cells are replaced with cells more like those seen in the intestines. It’s thought that this is a result of chronic inflammation.
There are no specific symptoms to indicate that you have developed Barrett’s esophagus. However, the symptoms of GERD that you are likely to experience include:
- frequent heartburn
- chest pain
- difficulty swallowing
Barrett’s is usually found in people with GERD. However, according to the National Center for Biotechnology Information (NCBI), it only affects about 5 percent of people with acid reflux.
Certain factors may put you at higher risk for Barrett’s esophagus. These include:
- being male
- having GERD for at least 10 years
- being white
- being older
- being overweight
Esophageal cancer and dysplasia
Barrett’s esophagus increases the risk of esophageal cancer. However, this cancer is uncommon even in people with Barrett’s esophagus. According to the NCBI, statistics have shown that over a period of 10 years, only 10 out of 1,000 people with Barrett’s will develop cancer.
If you are diagnosed with Barrett’s esophagus, your doctor may want to watch for early signs of cancer. You will need regularly scheduled biopsies. Examinations will look for precancerous cells. The presence of precancerous cells is known as dysplasia.
Regular screening tests can detect cancer at an early stage. Early detection prolongs survival. Detecting and treating precancerous cells may even help prevent cancer.
There are several treatment options for Barrett’s esophagus. Treatment depends on whether you have dysplasia and to what degree.
Treatment for people with no or low-grade dysplasia
If you don’t have dysplasia, you may just need surveillance. This is done with an endoscope. An endoscope is a thin, flexible tube with a camera and light.
Doctors will check your esophagus for dysplasia every year. After two negative tests, this can be extended to every three years.
You may also be treated for GERD. GERD treatment can help keep acid from further irritating your esophagus. Possible GERD treatment options include:
- dietary changes
- lifestyle modifications
Treatment for people with high-grade dysplasia
Treatment is different with serious dysplasia. The goal is to remove the precancerous cells. This can be done in several ways. All methods carry a risk of serious side effects. Discuss the risks in detail with your physician before deciding on a treatment. Potential treatments include the following:
- Endoscopic mucosal resection is performed using an endoscope. Damaged areas of the esophageal lining are cut away and removed.
- Photodynamic therapy uses light to destroy precancerous cells. First the cells are sensitized with medication. Then they are exposed to light using an endoscope.
- Cryotherapy uses an endoscope to freeze abnormal cells, resulting in cell death.
- Radiofrequency ablation uses energy to destroy cells in your esophagus. A special balloon inserted into your esophagus heats up and kills the abnormal cells.
- Surgery can also be used to remove the affected portion of your esophagus. However, this can have particularly serious complications. It’s usually not considered if you don’t have a diagnosis of esophageal cancer.
Diagnosis and treatment of GERD may help to prevent Barrett’s esophagus. It may also help keep the condition from progressing.