Barrett’s Esophagus is a condition in which the lining at the junction of the esophagus and stomach is replaced with tissue that is similar to intestinal tissue – a process known as “metaplasia.”
The exact prevalence and incidence of Barrett’s Esophagus is unknown but it is estimated that approximately 6-12% of patients with chronic Gastroesophageal Reflux Disease (GERD) will develop Barrett’s. Factors that additionally increase one’s risk include: Caucasian ethnicity, male gender, obesity, smoking, advanced age, concurrent hiatal hernia and chronic nocturnal GERD. Based on your overall risk Dr. Mantas is able to determine if and the frequency at which you need to be screened for Barrett’s esophagus.
Barrett’s is diagnosed during upper endoscopy. Areas visually suspicious for Barrett’s Esophagus are then biopsied to determine the extent and degree of change. Dr. Mantas has specialty training in additional modalities to aid in the diagnosis of Barrett’s including endoscopic microscopy and virtual chromoendoscopy.
There is some evidence that eating a diet high in fruits, vegetables and vitamins and using aspirin and other non-steroidal anti-inflammatory drugs can reduce one’s risk of Barrett’s Esophagus.
Barrett’s Esophagus is important to diagnosis as it increases one’s risk of a deadly form of esophageal cancer known as adenocarcinoma. Barrett’s Esophagus transitions to cancer through a series of changes known as dysplasia. Factors that increase your risk of conversion include long segment Barrett’s Esophagus, a family history of esophageal cancer and younger age of onset. Approximately 0.3-6% of patients with Barrett’s Esophagus will develop esophageal cancer per year. Alarmingly, approximately 95% of patients with esophageal cancer did not know they had preceding Barrett’s Esophagus!
Dr. Mantas is able to determine the best treatment option for you. Treatments include medications including proton pump inhibitors, endoscopic ablative therapies including radio-frequency ablation and endoscopic mucosal resection and surgery. Following treatment periodic surveillance with endoscopy is needed to assess healing.
A variety of other disorders can affect the esophagus. Suggestive symptoms include chest or upper abdominal pain, nausea, vomiting, regurgitation, troubled swallowing, food sticking, pain after swallowing, indigestion, heartburn and hiccups. Please visit Dr. Mantas if you feel that you have an esophageal disorder. Other common disorders include strictures, achalasia, eosinophilic esophagitis and esophageal cancer.