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WHAT IS BARRETT’S OESOPHAGUS?

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

Indications, Safety, and Warnings   Important Safety Information

BARRETT’S OESOPHAGUS

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

About 1.5 million British adults have Barrett’s oesophagus, but only 115,000 have been diagnosed.3 Barrett’s oesophagus is the primary risk factor for oesophageal cancer and can increase a person’s risk by 50 times or more.5-7

Infographic depicting the risk of oesophageal cancer in Barrett's oesophagus patients.

ASSESS YOUR RISK

Risk Assessment Tool (.pdf)
Complete the risk assessment tool to identify your risk level for Barrett’s oesophagus and oesophageal cancer. Share the results with your doctor at your next appointment.

DOWNLOAD TOOL

BARRETT’S OESOPHAGUS SYMPTOMS

People with Barrett’s oesophagus may not experience any symptoms.8 However, chronic heartburn, difficulty swallowing, nausea, chest pain, and other symptoms of GORD 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 oesophagus include:9

  • Obesity
  • Caucasian ethnicity
  • Family history
  • Male gender

To know for sure if you have Barrett’s oesophagus, consult a gastroenterologist (GI). Barrett’s oesophagus 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 oesophagus can progress to more serious stages, potentially resulting in oesophageal adenocarcinoma, a type of oesophageal cancer.5,6,10

There are three stages of Barrett’s oesophagus, 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 oesophagus is present, but no precancerous changes are visible in the cells of your oesophageal lining.
  • Low-Grade Dysplasia: Cells show early signs of precancerous changes that could lead to oesophageal cancer.
  • High-Grade Dysplasia: Oesophagus cells display a high degree of precancerous changes, thought to be the final step before oesophageal cancer.

Stages of Barrett's Oesophagus

  1. Normal, healthy oesophagus
  2. Oesophagus damaged by prolonged acid exposure
  3. Barrett's oesophagus tissue
  4. Dysplastic Barrett's oesophagus
  5. Oesophageal adenocarcinoma
Illustration of the various stages of esophageal damage caused by GERD, Barrett's esophagus and esophageal cancer.

OESOPHAGEAL ADENOCARCINOMA

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

An increase in population mortality for oesophageal cancer is predicted to increase over the next 10 years, it makes up 3% of all cancers in women and 6% of all cancers in men.16 Dysplastic Barrett’s esophagus is associated with an increased risk of developing oesophageal adenocarcinoma.17, 18 Only 12% of patients survive for at least 5 years after the diagnosis of oesophageal adenocarcinoma.4 There has been a six fold increase in the absolute incidence of oesophageal adenocarcinoma10.  Patients with Barrett’s esophagus are 30 to 125 times more at risk of developing EAC than patients without the condition.13 

The good news is that there is treatment available. Radiofrequency ablation has been shown to eradicate Barrett’s oesophagus and significantly reduce the risk of progression to high-grade dysplasia and oesophageal adenocarcinoma.8,14,15

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

Cancer Research UK. Oesophageal cancer statistics - https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oesophageal-cancer - access as of May 2019

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

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

14

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.

15

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.

16

Farthing, M., Roberts, S.E., Samuel, D.G., Williams, J.G., Thorne, K., Morrison-Rees, S., John, A. and Akbari, A. (2014) ‘Survey of digestive health across Europe: Final report. Part 1: The burden of gastrointestinal diseases and the organisation and delivery of gastroenterology services across Europe’, United European Gastroenterology Journal, 2(6), pp. 539–543. doi: 10.1177/2050640614554154

17

Shaheen NJ, Sharma P, et al. Radiofrequency Ablation in Barrett’s Esophagus with Dysplasia. New England Journal of Medicine. 2009 May;360(22):2277-2288

18

Bray F, et al. Estimates of global cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013 Mar 1;132(5):1133-45. doi: 10.1002/ijc.27711. Epub 2012 Jul 26