Barrett's Esophagus

Barrett's esophagus is a chronic condition in which the lining of the esophagus — the "food tube" that connects the throat to the stomach — is damaged by bile or acid from the stomach. The damage is characterized by changes in the cells at the base of the esophagus. The esophageal cells gradually elongate and thicken, and eventually come to resemble intestinal cells.

Normally, the body has a mechanism to prevent stomach acid from reaching the esophagus. A circular band of muscle at the lower end of the esophagus, called the lower esophageal sphincter, seals shut and prevents stomach contents from rising up. But certain conditions, such as chronic gastroesophageal reflux disease (GERD) or obesity, weaken the sphincter. When that happens, stomach acid can gurgle up and burn the lower end of the esophagus.

Occasional heartburn is harmless, but chronic GERD can set the stage for Barrett's esophagus. Experts estimate that between 10 and 15 percent of people with GERD will develop Barrett's esophagus.

Barrett's esophagus is serious because it increases a person's risk for a type of cancer called esophageal adenocarcinoma. In most cases, precancerous cells, called dysplasia, appear first and offer a chance for early intervention.

Our Approach to Barrett's Esophagus

UCSF's gastroenterologists specialize in preventing, diagnosing and treating Barrett's esophagus. We use an endoscope – a thin, flexible tube fitted with a camera – to determine whether precancerous cells have developed in the lining of the esophagus. If not, or if the cells are in their early stages, we monitor the patient and prescribe medications that protect the esophagus by limiting the stomach's acid production. For more advanced cases, we usually can use state-of-the-art, minimally invasive techniques to remove or destroy the precancerous cells. The last option is surgically removing the damaged portion of the esophagus.