Barrett's Esophagus - CHI Health, Omaha, Nebraska (NE)

Barrett's

The Barrett's Clinic at the Alegent Creighton Health Esophageal Center offers careful, systematic follow-up of patients which may allow the early detection of cancer. Patients are entered into a computerized database which is used to schedule periodic endoscopy and follow-up consultations.

What is Barrett's Esophagus?
Barrett's esophagus is a condition resulting from prolonged gastroesophageal reflux disease and is a risk factor for esophageal cancer. Barrett's esophagus is estimated to affect about 1,000,000 adults in the United States.

What is the Significance of Barrett's Esophagus?
Individuals with Barrett's are 100 times more likely of developing esophageal cancer. Esophageal adenocarcinoma is the fastest growing cancer in the United States. The incidence has increased 700 fold in the last 25 years.

What Causes Barrett's?
Long standing gastroesophageal reflux disease (GERD) is the only known risk for development of Barrett's esophagus. GERD exposes the esophagus to gastric and duodenal secretions. The enzymes, bile and acid cause damage and erosion of the lining of the esophagus.

Who is at Risk to Develop Barrett's?
Any individual with long standing symptoms of GERD is at risk.

What are the Symptoms of Barrett's Esophagus?
Barrett's esophagus does not cause symptoms itself and is important only because it seems to precede the development of a particular kind of cancer—esophageal adenocarcinoma.

How do I Know if I Have Barrett's?
The only way to diagnose Barrett's esophagus is to perform an endoscopy and to take a biopsy of the suspected area.

I Have Heartburn. When Should I Worry About Barrett's Esophagus/cancer?
Any person who experiences difficulty in swallowing even once should get an endoscopy. This symptom can be ignored under any circumstances. We also believe that sudden improvement in symptoms should warrant an endoscopy. For example, if a person is relatively symptom-free on medication, but now notices that he is not feeling that bad (as earlier), even if he misses his medications. Most people view this as a good sign; however this individual may have developed either Barrett's esophagus or early cancer and needs an endoscopy.

Is There Anything I can do to Decrease the Risk of Cancer?
Unfortunately, there is no proven intervention that decreases the risk of progression to cancer. However, there is some evidence that anti-reflux surgery might decrease progression to cancer. Additionally, anti-reflux surgery provides better symptom control of GERD symptoms when compared to medicines.

Treatment

Surgery or other procedures may be recommended if a biopsy shows cell changes that are very likely to lead to cancer. Such changes are called severe or high-grade dysplasia.

Some of the following procedures remove the harmful tissue in your esophagus, where the cancer is most likely to develop.

  • Photodynamic therapy (PDT) uses a special laser device, called an esophageal balloon, along with a drug called Photofrin.
  • Other procedures use different types of high energy to destroy the precancerous tissue.
  • Surgery removes the abnormal lining.