WHAT IS BARRETT’S ESOPHAGUS?

Barrett’s esophagus is a precancerous disease that affects the lining of the esophagus.

BARRETT’S ESOPHAGUS

Barrett’s esophagus is a precancerous disease that affects the lining of the esophagus. It occurs when stomach acids and enzymes leak back into the esophagus. Over time, the chronic injury from the acid backwash cause the esophagus cells to change. It is common for a patient with untreated gastroesophageal reflux disease (GERD) to develop Barrett’s esophagus.1 Estimates suggest that over 95% of Barrett’s esophagus patients also have GERD.2

About 12 million American adults have Barrett’s esophagus, but only 1.5 million have been diagnosed.3 Barrett’s esophagus is the primary risk factor for esophageal cancer and can increase a person’s risk by 50 times or more.4-7

Infographic illustrating that 82% of people with esophageal cancer will die within 5 years of diagnosis.

BARRETT’S ESOPHAGUS SYMPTOMS

People with Barrett’s esophagus may not experience any symptoms.8 However, chronic heartburn, difficulty swallowing, nausea, chest pain, and other symptoms of GERD may indicate a need for further testing.

In addition to suffering from chronic heartburn, other factors that may put a person at risk for Barrett’s esophagus include:9

  • Obesity
  • Caucasian ethnicity
  • Family history
  • Male gender

To know for sure if you have Barrett’s esophagus, consult a gastroenterologist (GI). Barrett’s esophagus cannot be diagnosed by symptoms alone. Diagnosing Barrett’s is dependent on an upper endoscopy.

SEE DIAGNOSIS AND TREATMENT OPTIONS
Sitting in kitchen, man coughs while next to his wife.

DISEASE PROGRESSION AND COMPLICATIONS

Barrett’s esophagus can progress to more serious stages, potentially resulting in esophageal adenocarcinoma, a type of esophageal cancer.5,6,10

There are three stages of Barrett’s esophagus, which range from intestinal metaplasia without dysplasia to high-grade dysplasia. Dysplasia signifies the presence of abnormal cell growth within bodily tissue. The presence of dysplasia is not considered cancer but may increase the risk of developing cancer, so medical guidelines recommend treatment.11,12

  • Intestinal Metaplasia Without Dysplasia: Barrett’s esophagus is present, but no precancerous changes are visible in the cells of your esophageal lining.
  • Low-Grade Dysplasia: Cells show early signs of precancerous changes that could lead to esophageal cancer.
  • High-Grade Dysplasia: Esophagus cells display a high degree of precancerous changes, thought to be the final step before esophageal cancer.

STAGES OF BARRETT’S ESOPHAGUS

Normal, healthy esophagus

Normal, healthy esophagus  

 

Esophagus affected by low-grade dysplasia (LGD)

Low-grade dysplasia
 

Esophagus damaged by erosive esophagitis (EE), prolonged acid exposure

Esophagus damaged by prolonged acid exposure

Esophagus affected by high-grade dysplasia (HGD)

High-grade dysplasia
 

Esophagus progressed to nonplastic Barrett's esophagus (NBDE)

Nondysplastic Barrett’s esophagus

 

Esophagus suffering esophageal adenocarcinoma

Esophageal adenocarcinoma
 

ESOPHAGEAL ADENOCARCINOMA

Cancer occurs when the abnormal cells involved in Barrett’s esophagus engage in rapid and uncontrolled growth and invade the deeper layers of your esophagus. This type of esophageal cancer is called esophageal adenocarcinoma (EAC) and it can spread beyond the esophagus.

Although still considered rare, EAC is the most rapidly rising cancer in the U.S.13,14 Between 1975 and 2001, the incidence of esophageal adenocarcinoma rose approximately six-fold.10 In addition, mortality increased more than seven-fold.15 Patients with Barrett’s esophagus are 30 to 125 times more at risk of developing EAC than patients without the condition.16 Only 18% of patients survive at least five years after the diagnosis of esophageal cancer.14

The good news is that there is treatment available. Radiofrequency ablation has been shown to eradicate Barrett’s esophagus and significantly reduce the risk of progression to high-grade dysplasia and esophageal adenocarcinoma.8,17,18

LEARN ABOUT RADIOFREQUENCY ABLATION

Information and resources on this site should not be used as a substitute for medical advice from your doctor. Always discuss diagnosis and treatment information including risks with your doctor. Keep in mind that all treatment and outcome results are specific to the individual patient. Results may vary.

1

Dymedex Market Development Consulting, Strategic Market Assessment, Barrx, October 30, 2014. References 1, 3-5, 7-13, 15, 16, 20-23, 25, 27-29, 40-44, 46, 48-50, 54-59, 62-66, 68-75, 78, 79, 81, 82, 87-89, and 97 from the full citation list, access at http://www.medtronic.com/giclaims

2

Spechler SJ. Barrett’s esophagus. N Engl J Med. 2002;346(11):836-42.

3

Dymedex Market Development Consulting, GERD Sizing and Segmentation for pH Testing, February 13 2015.

4

SEER Cancer Statistics Factsheets: Esophageal Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/esoph.html.

5

De Jonge PJ, van Blankenstein M, Looman CW, Casparie MK, Meijer GA, Kuipers EJ. Risk of malignant progression in patients with Barrett’s oesophagus: a Dutch nationwide cohort study. Gut. 2010;59:1030-6.

6

Hvid-Jensen F, Pedersen L, Drewes AM, Sorensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365:1375-83.

7

Wani S, Falk G, Hall M, Gaddam S, Wang A, Gupta N, et al. Patients with nondysplastic Barrett’s esophagus have low risks for developing dysplasia or esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2011;9(3):220-7.

8

Shaheen NJ, Richter JE. Barrett’s oesophagus. Lancet. 2009;373(9666):850-61.

9

Spechler SJ, Souza RF. Barrett’s esophagus. NEJM. 2014;371:836-45.

10

Pohl H, Welch HG. The role of over diagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97:142-6.

11

Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. The American Journal Of Gastroenterology. 2016;111(1):30-50. doi:10.1038/ajg.2015.322.

12

Wani S, Qumseya B, Sultan S, et al. Endoscopic eradication therapy for patients with Barrett’s esophagus-associated dysplasia and intramucosal cancer. Gastrointestinal Endoscopy. 2018;87(4):907-931.

13

Reid BJ, Weinstein WM. Barrett’s esophagus and adenocarcinoma. Gastroenterology Clinics of North America. 1987;38:477-92.

14

"What Are the Key Statistics about Cancer of the Esophagus?" Cancer.org. 2006. American Cancer Society. Accessed October 2007.

15

Gilbert EW, Luna RA, Harrison VL, Hunter JG. Barrett’s esophagus: a review of the literature. J Gastrointest Surg. 2011;15:708-18.

16

Eisen GM. Ablation therapy for Barrett's esophagus. Gastrointestinal Endosc. 2003;58:760-9.

17

Phoa KN, van Vilsteren FG, Weusten BL, Bisschops R, Schoon EJ, Ragunath K, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014;311(12)1209-17. doi:10.1001/jama.2014.2511.

18

Wolf WA, Pasricha S, Cotton C, Li N, Triadafilopoulos G, Raman Muthusamy V, et al.  Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett’s Esophagus. Gastroenterology. 2015;149(7):1752-1761.