Barrett’s Esophagus

Dr. Matthew Smith explains what Barrett's esophagus is and how it can be treated.

What is Barrett's esophagus?

Barrett's esophagus is when the internal cell lining of the esophagus change. Usually this is caused by refluxes or acid coming up. Sometimes people can feel that acid come up into their esophagus, and sometimes they can't. It's called intestinal metaplasia or changing of those cells from one type of cell to the other. Your body's doing that on purpose in order to try to better combat that acid by changing them to stomach cells where the acid production is higher. However, in a very small portion of that population, that change can lead to an increased risk for cancer.

How is Barrett's esophagus treated?

I can treat that disease process endoscopically with a scope down the throat and into the esophagus. There are different techniques to treat Barrett's esophagus. You can take large biopsies of the area and slough off some of that mucosal lining to help it reheal. You can also do what we call radiofrequency ablation on those areas. This burns the lining of the esophagus to help those cells rejuvenate and help kill those dysplastic cells before they become more worrisome for cancer. 

Does Barrett's esophagus always need surgical intervention?

Barrett's esophagus is not always a huge precursor to cancer. A lot of people end up having some metaplasia. Not all of Barrett's esophagus needs to be treated with endoscopic techniques other than just surveillance with scopes down the throat to look at it every three to five years. If it's more worrisome, than maybe every one to two years.