Your esophagus is a tube that goes from your throat to your stomach. When you swallow, food travels down this tube and into your stomach. Gastroesophageal reflux disease (also called GERD) is a health problem that happens when stomach acid goes up into your esophagus. If this happens over a long period of time, the acid can make changes in the lining of your esophagus. This condition is called Barrett's esophagus. In some cases, it can lead to cancer.
Gastroesophageal reflux disease (GERD)
You should ask your doctor about Barrett's esophagus if you have heartburn 3 or more times each week, or if you have had heartburn for many years. You should also see your doctor if you have trouble swallowing, pain when you swallow, unexpected weight loss, blood in your vomit or bowel movements, or bowel movements that look like black tar.
People who have had GERD for a long time have a higher risk of getting Barrett's esophagus. This problem is much more common in white and Hispanic men. Smokers and people who are obese also have a higher risk. Barrett's esophagus is more common in people older than 50 years of age. Most people who have Barrett's esophagus are diagnosed after age 60.
Barrett's esophagus usually is treated with medicines called proton pump inhibitors. These medicines reduce the amount of acid in your stomach. In some cases, surgery is used to keep stomach acid out of the esophagus. Your doctor may recommend that you make some lifestyle changes, such as quitting smoking if you smoke, exercising, losing weight, and avoiding foods that make your heartburn worse.
If you have Barrett's esophagus, your doctor may have you see a gastroenterologist (a doctor who specializes in stomach problems). Your family doctor or the gastroenterologist may want you to have a test called an upper endoscopy. In this test, a flexible tube is guided down your throat and the doctor looks inside your esophagus and stomach for abnormal cells. Your doctor will probably treat you for GERD before doing an endoscopy.
Patients who have 2 endoscopies in a row that show no abnormal cells should have an endoscopy every 3 to 5 years.
Patients who have somewhat abnormal cells should get an endoscopy every year. Patients who have more highly abnormal cells should get an endoscopy every 3 months or have surgery to remove the abnormal tissue. Abnormal cells can lead to cancer.
Barrett's Esophagus by MD Shalauta, M.D., and R Saad, M.D. (American Family Physician May 01, 2004, http://www.aafp.org/afp/20040501/2113.html)
11/11/05