Barrett’s esophagus is a condition that causes changes in the cells lining the esophagus – the tube that carries food and liquids from the throat and down into the stomach. The lining of the esophagus can be damaged by acid reflux from heartburn or gastroesophageal reflux disease, or GERD.
At the Barrett’s Esophagus Center at Cooper (part of the Digestive Health Institute) our world-renown experts have been at the forefront of Barrett’s esophagus research and care for decades and provide patients with a full array of diagnostic and treatment services.
Our experts are pioneers in radiofrequency ablation, performing among the highest number of procedures than any other health system in the country and are among the few providers offering cryotherapy as a treatment option for Barrett’s esophagus. They are also involved in cutting-edge clinical research, including an NIH study that will change the way Barrett’s esophagus is managed in the future.
Causes of Barrett's Esophagus
Barrett’s esophagus is often linked to gastroesophageal reflux disease (GERD), a common yet chronic condition in which the stomach's contents sometimes flow back up into the esophagus. Over time, this reflux can cause normal cells in the esophagus to turn into cells not usually found there. These new, abnormal cells take over because of the damage to the lining of the esophagus.
Some people with Barrett's esophagus have no symptoms. Others have symptoms caused by GERD, including heartburn, reflux, or trouble swallowing.
Risk Factors for Barrett's Esophagus
An estimated 7% of people in the U.S. are living with Barrett’s esophagus and the condition affects men twice as much as women.
The risk factors for developing Barrett’s esophagus include:
- Being a Caucasian male
- Being age 50 or older
- Being obese
- Having chronic heartburn or GERD
- Having a family history of Barrett’s esophagus, esophageal or gastric cancer
Cancer Risk from Barrett's Esophagus
Barrett's esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, if you have GERD or heartburn it’s important to have a procedure called an upper endoscopy to evaluate you for Barrett’s esophagus with possible precancerous cells, also called dysplasia. Precancerous cells discovered during an upper endoscopy can be treated to help prevent esophageal cancer.
Barrett's Esophagus Diagnosis
Barrett’s esophagus is primarily diagnosed through a non-surgical procedure called an upper endoscopy. While you are under sedation, a gastroenterologist inserts a thin, flexible tube called and endoscope into the mouth, down the throat and into the esophagus. The endoscope is equipped with a light and small camera so the gastroenterologist can examine and take images of the esophagus lining to see if there are any changes to the cells.
If any abnormal cells or tissues are suspected, the gastroenterologist will take samples, or a biopsy, during the procedure for evaluation by a pathologist to see if the changes indicate Barrett’s esophagus.
Barrett’s Esophagus Treatment at Cooper
The treatment for Barrett’s esophagus will depend on its type – or grade – based on the results of diagnostic tests. The grades for the condition include:
- Intestinal metaplasia without dysplasia (low risk of progression)
- Intestinal metaplasia with low-grade dysplasia (intermediate risk of progression)
- Intestinal metaplasia with high-grade dysplasia (high risk of progression)
For patients who have dysplasia, the treatment options include radiofrequency ablation, cryotherapy, endoscopic mucosal resection, endoscopic submucosal dissection or surgery.
Radiofrequency ablation (RFA) – an outpatient procedure that generates heat from radio waves to treat abnormal tissue in the lining of the esophagus. This procedure is typically performed three or four times over the course of a year to eliminate Barrett’s esophagus.
Cryotherapy – an outpatient procedure that uses extreme cold to freeze and destroy abnormal cells in the esophagus. The procedure is typically performed several times with a month or two between procedures to treat Barrett’s esophagus.
Endoscopic mucosal resection (EMR) – involves an advanced intervention gastroenterologist using an endoscope to suction, band and remove any precancerous cells and tissues from the lining of the esophagus.
Endoscopic submucosal dissection (ESD) – involves an advanced interventional gastroenterologist using a device called an endoscope to tunnel under a lesion and remove it as one piece.
Surgery – a procedure called an esophagectomy is performed using an advanced minimally invasive technique for patient with Barrett’s esophagus and larger cancers that cannot be removed through the endoscope. This procedure involves removing part or most of the esophagus.
Why Choose Cooper for Your Barrett’s Esophagus Care
Cooper’s multidisciplinary team includes gastroenterologists, pathologists, thoracic surgeons, general surgeons, nurse practitioners, nutritionists, and other health care professionals working together collaboratively to provide you or your loved one with the most advanced care possible.
The unparalleled expertise, cutting-edge technologies and advanced approaches to care at Cooper Barrett’s Esophagus Center are designed to keep our patients out of the operating room. In those cases where surgery is needed, Cooper has the expertise to perform minimally invasive procedures.