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DIAGNOSING BARRETT’S ESOPHAGUS REFLUX TESTING AND TREATMENT

To diagnose Barrett’s esophagus, your physician will need to perform an upper endoscopy.

IMPORTANCE OF EARLY DETECTION

Over 25 percent of gastroesophageal reflux disease (GERD) patients may progress to Barrett’s esophagus in their lifetime.1 Barrett’s esophagus is the primary risk factor for esophageal adenocarcinoma, a type of esophageal cancer.2-4

Barrett’s is more likely to occur in patients with certain risk factors, such as having frequent acid reflux symptoms, being obese, using tobacco, or having family history of Barrett’s or esophageal cancer.3,5 If you experience frequent GERD symptoms and have been regularly using medications to control heartburn for several years, speak to a gastroenterologist (GI) about screening for Barrett’s.

Doctor examines chest of male patient.

HOW IS BARRETT’S ESOPHAGUS DIAGNOSED?

Barrett’s esophagus cannot be diagnosed by symptoms. Diagnosing Barrett’s is dependent on an upper endoscopy performed by a GI or surgeon. This procedure enables the physician to directly visualize the esophagus and take tissue samples.

ENDOSCOPY WITH BIOPSY PROCEDURE

An endoscopy is a procedure performed under sedation that allows the physician to directly visualize esophageal tissue and identify any abnormal tissue. An endoscope is a thin, flexible tube with a small camera attached. During the procedure, the endoscope is guided down the throat to inspect the esophagus and capture pictures of the tissue.

Your physician will also perform a biopsy and collect a small tissue sample for further examination. This sample will be used to determine if there is dysplasia (abnormal cell growth) present in the lining of your esophagus.

Your tissue sample will be classified into one of the following:

  • 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
 

Referenced path does not exist

1

Dymedex Market Development Consulting, Strategic Market Assessment, GERD, October 30, 2014. References 1-3, 6-15, 22, 23, 25, and 34 from the full citation list, access at http://www.medtronic.com/giclaims

2

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.

3

Spechler S. et al. Barrett’s Esophagus. N Engl J Med 2014; 371:836-45.

4

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.

5

Evans JA et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointestinal Endoscopy. 2012;27(6):1087-1094