Barrett's Esophagus Normal Abnormal The esophagus is the tube carrying food from the mouth to the stomach.  In a healthy esophagus, the tube is comprised of a cell type called squamous epithelium.  At the junction between the esophagus and the stomach these cells may undergo a change (or be replaced by) a cell type called metaplastic epithelium cells, thought to be caused by chronic irritation from long-standing acid reflux.  Approximately 10% of patients with long-standing acid reflux develop Barrett's esophagus.  This is a pre-cancerous condition. None presented from the Barrett's esophagus Symptoms of longstanding acid reflux -- heartburn, nausea, regurgitation, and swallowing difficulties usually 1/3 of all affected do not even have acid reflux symptoms Chronic acid reflux disease Endoscopy (scope is passed into the esophagus) and biopsies taken for lab analysis Aggressive treatment for reflux disease, usually with proton-pump inhibitors such as Prilosec Surgical fundoplication (area of stomach is sutured over the esophagus to prevent reflux) is performed in some cases Endoscopic ablation -- area of the abnormal Barrett's cells is destroyed with electrical probes or lasers Mild Barrett's esophagus should be followed with repeat endoscopy every six to twelve months (after above treatments). Severe Barrett's esophagus is often treated surgically (area surgically removed) due to the risk of invasive cancer (ablation may be considered if the patient is a poor candidate for surgery). This is a pre-cancerous condition and high-grade Barrett's esophagus has a 30-40% risk of turning into invasive adenocarcinoma. Gastroesophageal Reflux Disease Esophageal Cancer