Barrett's Esophagus
UMMC gastroenterologists have more than 15 years of experience in treating Barrett's esophagus and see a large volume of patients with this problem.
They work together with a diverse team of physicians — including thoracic surgeons, medical and radiation oncologists, and pathologists — to treat complicated cases.
In addition, the University of Maryland Medical Center was one of the first sites to pioneer endoscopic cryotherapy, a treatment that uses low pressure liquid nitrogen spray delivered through an upper endoscope to destroy abnormal esophageal tissue.
What Is Barrett's Esophagus?
In Barrett's esophagus, the cells lining the esophagus change and become similar to the cells lining the intestine. Barrett's esophagus does not cause symptoms itself and is important only because it seems to precede the development of a particular kind of esophageal cancer. Barrett's esophagus is associated with GERD (gastroesophageal reflux disease).
Barrett's esophagus is diagnosed by upper gastrointestinal endoscopy and biopsy. People who have Barrett's esophagus should have periodic esophageal examinations.
Barrett's Esophagus and Cancer
The risk of developing esophageal cancer is 30 to 125 times higher in people who have Barrett's esophagus than in people who do not. This type of cancer is increasing rapidly in white men. This increase may be related to the rise in obesity and GERD.
When pre-cancerous cells appear in the Barrett's tissue, this condition is called dysplasia. The process of change from Barrett's to cancer seems to happen in only a few patients, less than 1 percent per year, and over a relatively long period of time.
Barrett's Esophagus Treatment
- Cryotherapy - When there is a high number of precancerous cells, cryotherapy is a treatment that can offer a long-term solution.
- Observation - Patients have upper endoscopy usually every three to six months. If cancer develops, it is treated.
- Lifestyle Change and Medications - Most patients are advised to avoid certain foods and behaviors that increase the risk of reflux. Taking acid-blocking drugs for GERD may result in improvements in Barrett's esophagus.
- Surgery - Surgical removal of the esophagus has a high success rate but involves a long recovery time, alteration in eating habits and the risk of complications. This is usually recommended for those in good health who have developed high-grade dysplasia or early stage cancer.
- Photodynamic therapy (PDT) - A light-sensitizing drug and laser destroy the abnormal tissue. While there is more data on its success, PDT’s drawbacks are pain, the risk of esophageal scarring and the need to avoid direct sunlight for four to six weeks after treatment.
- Endoscopic ablation - In these techniques, the Barrett's lining is destroyed and healthy tissue is allowed to grow in its place. These treatments are given during upper endoscopy, and no surgery is required.
- Radiofrequency ablation - This very localized treatment kills the abnormal cells with heat. A catheter with a balloon at the tip delivers short bursts of energy to the treatment area.
Who Is at Risk for Barrett's Esophagus?
- Age - Barrett's esophagus is most commonly diagnosed in middle-aged and older adults; the average age at diagnosis is 55 years. Children can develop Barrett's esophagus, but rarely before the age of 5 years.
- Gender - Men are more commonly diagnosed with Barrett's esophagus than women.
- Ethnic background - Barrett's esophagus is equally common in white and Hispanic populations and is uncommon in black and Asian populations.
- Lifestyle - Smokers are more commonly diagnosed with Barrett's esophagus than nonsmokers.
For patient inquiries, call 1-800-492-5538 or you may call the division directly at 410-328-5780.