Barrett’s Esophagus

This condition generally results from having gastric reflux that causes stomach contents to back up into the lower section of the esophagus. Over time, this reflux (GERD) irritates the esophagus, which can cause cells that resemble intestinal cells to replace the lining. As the condition progresses, these cells become increasingly disordered. Long-standing acid reflux disease is common in those who develop Barrett’s Esophagus, which affects about 1 percent of adults in the U.S. Millions of people – 70 percent of adults, at some time in their lives – have acid reflux. About 10 percent of people with GERD will develop Barrett’s Esophagus.

Barrett's esophagus
Barrett’s esophagus (red appearing mucosa in distal esophagus) prior to biopsy demonstrated high-grade dysplasia.

Patients with this condition can go on to develop esophageal cancer, which can be deadly. In those with advanced high-grade dysplasia, the risk that the condition will develop into cancer can be as high as 6 percent a year.

Clinicians can assess the risk for esophageal cancer by looking at abnormal cells under a microscope. Early Barrett’s Esophagus (low-grade dysplasia) has a low risk of cancer and is handled by periodic surveillance and sometimes biopsies. The greater the dysplasia, the more frequent the monitoring.

Treating Barrett’s Esophagus at Siteman

In 2009, researchers at Siteman Cancer Center started using radiofrequency ablation to treat Barrett’s Esophagus. This approach involves using heat generated by radio waves to destroy diseased tissue. It can eliminate signs of the potentially cancer-causing disorder and reduce the risk that the disease will progress.

In this procedure, a scope is inserted through the mouth and destroys the abnormal tissue with heat. Meanwhile, the deeper layers of the esophagus remain undamaged.

Patients with high-grade dysplasia (which is associated with more advanced Barrett’s Esophagus) may be eligible for the treatment. In addition to treatment, patients should maintain a regimen of anti-reflux medication to prevent more abnormal cells from developing.

Patients with severe dysplasia that is resistant to ablation may require surgery. This usually involves removing most of the esophagus, pulling a portion of the stomach up into the chest and attaching it to what remains of the esophagus.