Barrett’s Esophagus – Symptoms and Causes
Overview
Barrett’s esophagus occurs when the normal flat pink lining of the esophagus (the tube connecting mouth to stomach) becomes damaged by acid reflux, causing the tissue to thicken and redden.
This condition develops because of problems with the lower esophageal sphincter (LES), a crucial valve between the esophagus and stomach.
When the LES fails, stomach acid flows back into the esophagus, causing gastroesophageal reflux disease (GERD).
Common symptoms include:
- Heartburn
- Regurgitation
- Chest pain
In some people with long-term GERD, the constant acid exposure triggers changes in the cells lining the lower esophagus, resulting in Barrett’s esophagus.
The most significant concern with Barrett’s esophagus is its connection to esophageal cancer. Though the risk remains relatively small, regular monitoring is essential.
Doctors recommend periodic examinations with detailed imaging and biopsies to check for precancerous cells (dysplasia).
Early detection matters: If precancerous changes are found, treatments can prevent progression to cancer.
Signs and Symptoms
Barrett’s esophagus often develops from long-term acid reflux damage.
Common symptoms include:
- Frequent heartburn
- Stomach contents flowing back up into throat
- Trouble swallowing
- Chest pain (less common)
Interestingly, about half of people with Barrett’s esophagus have few or no acid reflux symptoms.
When to Get Medical Help
Talk to your doctor if you’ve experienced heartburn, acid reflux, or regurgitation problems for more than five years. This might indicate a need to check for Barrett’s esophagus.
Get emergency medical care if you have:
- Chest pain (which might be a heart attack)
- Swallowing difficulties
- Vomiting that contains red blood or dark material resembling coffee grounds
- Black, tar-like, or bloody stool
- Weight loss you didn’t plan for
These symptoms may indicate serious complications that need immediate attention.
Causes
The root cause of Barrett’s esophagus remains unclear.
While many patients have gastroesophageal reflux disease (GERD), others show no reflux symptoms, something doctors call “silent reflux.”
The key factor appears to be stomach acid flowing back into the esophagus. This backward flow, whether it causes noticeable symptoms or not, damages the esophageal tissue.
Over time, this persistent acid exposure triggers changes in the cells lining the swallowing tube.
These cellular changes represent the body’s attempt to protect itself by replacing normal esophageal tissue with cells that better resist acid damage.
Risk Factors
Several factors may increase your likelihood of developing Barrett’s esophagus:
Personal Characteristics
- Gender: Men face significantly higher risk than women.
- Age: More common in people over 50, though can occur at any age.
- Race: White individuals have higher risk compared to other racial groups.
- Family History: Having relatives with Barrett’s esophagus or esophageal cancer raises risk.
Health and Lifestyle Factors:
- Persistent acid reflux or GERD, especially when unresponsive to proton pump inhibitors
- Tobacco use (current or former smokers)
- Excess weight, particularly abdominal fat
- Chronic heartburn that requires regular medication
Possible Health Risks
Barrett’s esophagus slightly increases a person’s chance of developing esophageal cancer. However, the risk remains quite small. Most people with this condition will never face esophageal cancer in their lifetime. This includes those who have precancerous cell changes.
The small percentage of patients who do develop complications should maintain regular medical check-ups to monitor their condition.
