What Does Barrett’s Esophagus Mean and Why It Matters

Medical illustration of esophagus highlights the area damaged by GERD when chronic reflux causes Barrett's esophagus

Almost every American suffers from intermittent acid reflux; however, when heartburn becomes chronic, this is known as gastroesophageal reflux disease or GERD. GERD is one of the fastest growing GI complications in the United States and is mainly a result of the decline in physical activity, combined with less healthy diets across American society. Unfortunately, the effects of GERD do not simply end with discomfort, which may be severe, by the way; instead, there is the potential for significant longer-term complications, some of which cannot be reversed. One of these is known as Barrett’s esophagus.

What Exactly Is Barrett’s Esophagus?

Barrett’s esophagus is a condition in which the cellular lining of the esophagus begins to morph to accommodate the constant wash of acid coming up from the stomach. To understand this, learning more about the esophagus and stomach function is essential. The esophagus is the long thin tube that delivers food and drinks from the mouth into the stomach. At the base of the esophagus is a small valve known as the lower esophageal sphincter or LES. The LES works by opening when food and drinks come down the esophagus but then closes to prevent stomach acid from moving up into the esophagus. The environment in the stomach could not be more different from that of the esophagus. The stomach secretes highly acidic liquid to begin breaking down food. This is a critically important part of digestion, but when the acid escapes from the stomach and into the esophagus, it can cause significant discomfort.

How Does the Acid Escape?

When the LES malfunctions, it may not open and close normally. Anyone can occasionally experience acid reflux when they overeat, eat particularly spicy foods, or eat some acid-producing foods like tomatoes, onions, and garlic. For these people, acid reflux can be controlled with antacids, behavioral changes, and modifications to diet.

However, for those patients that do not control their chronic acid reflux, the esophagus begins to adapt to the constant wash of acid by morphing on a cellular level. An esophagus with Barrett’s looks more like a stomach or intestinal lining than esophageal tissue. This can cause chronic inflammation and stricture, motility issues like difficulty swallowing, and even increase the risk of esophageal cancer, a very aggressive and ultimately silent form of cancer in its earliest stages.

How We Treat Barrett’s Esophagus

Once the lining of the esophagus has morphed, there is no way to bring it back to its original state. However, this does not mean quitting trying to improve your health. First, it is crucial to identify Barrett’s and the degree of risk of esophageal cancer. We may need to biopsy the area to know more. Ultimately, the next and most crucial step is to control the acid refluxing back into the esophagus. While front-line PPIs are effective, they are not indicated for long-term use. Therefore, the definitive treatment for Barrett’s esophagus is anti-reflux surgery. We offer two minimally invasive surgeries. First is a fundoplication, which involves wrapping the upper portion of the stomach around the lower esophageal sphincter to give it more compression force. The second is a minimally invasive surgery known as LINX, which simply places a bracelet of titanium beads around the LES to offer similar compression. Each patient has a different circumstance and talking with Dr. Huguet about your best next options is essential. We encourage you to contact our office to schedule a consultation and learn more.