Barrett’s Esophagus – GE Junction & Lower Esophagus

What it is:
A condition where chronic acid exposure causes normal squamous cells of the lower esophagus to be replaced with intestinal-type columnar cells (metaplasia). It is considered a precancerous condition.

Symptoms:

Often asymptomatic. When present, symptoms typically relate to GERD:

• Chronic heartburn

• Regurgitation

• Chest discomfort

• Difficulty swallowing in advanced cases

Causes / Risk Factors:

• Long-standing gastroesophageal reflux disease (GERD)

• Hiatal hernia

• Obesity

• Male sex and older age

• Smoking history

• Family history of Barrett’s or esophageal adenocarcinoma
  
  

Treatment:

• Long-term acid suppression (PPIs)

• Lifestyle modifications (weight loss, diet changes, elevating head of bed)

• Endoscopic surveillance at recommended intervals

• Endoscopic eradication therapy (RFA, EMR) if dysplasia is present

• Rarely esophagectomy for high-grade dysplasia or early cancer