Conditions / Barrett's Esophagus
Barrett's Esophagus
Affects an estimated 10–15% of chronic GERD
Overview
Barrett's is a pre-cancerous condition where normal esophageal squamous cells are replaced by columnar cells (intestinal metaplasia) — the body's response to chronic acid injury. While Barrett's itself isn't cancer, it's the primary risk factor for esophageal adenocarcinoma.
How it's diagnosed
Upper endoscopy with biopsies. Graded by dysplasia: non-dysplastic, low-grade, high-grade. Surveillance intervals depend on dysplasia grade.
Triggers
- All GERD triggers
- Any acid exposure accelerates progression
- Alcohol significantly increases cancer risk
- Smoking dramatically increases cancer risk
- Obesity is a major risk factor
Symptoms
- Often ASYMPTOMATIC — Barrett's has no unique symptoms
- Background GERD symptoms
- Note: Barrett's patients often report LESS heartburn as damaged cells lose sensation
Complications if untreated
- Esophageal adenocarcinoma (0.1–0.5% per year)
- Up to 10% per year in high-grade dysplasia
- Esophageal stricture
Immediate relief
- Strict PPI therapy is mandatory
- Any flare-up warrants urgent medical attention
Long-term management
- Twice-daily PPI — slows Barrett's progression
- Regular endoscopic surveillance
- Non-dysplastic: every 3–5 years
- Low-grade: every 6–12 months
- High-grade: immediate intervention evaluation
- RFA (Radiofrequency Ablation) — standard treatment
- EMR for visible lesions
Diet
Most restrictive diet of all conditions. Zero tolerance for acid exposure. No alcohol ever. No smoking ever. Anti-inflammatory focus: omega-3s, turmeric, antioxidant-rich foods.
When to see a doctor
This condition REQUIRES a gastroenterologist. Surveillance schedule must be followed strictly. Never miss an appointment. This is potentially life-saving monitoring.
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