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Barrett’s esophagus

• Overview
• Symptoms
• Treatment
• Prevention

Treatment:

Treatment includes general measures to control gastroesophageal reflux, medications, photodynamic therapy (PDT), and surgery. Treatment may be important even if the patient doesn't feel any symptoms.

General measures include:

• Weight reduction
• Avoiding lying down after meals
• Sleeping with the head of the bed elevated
• Taking medication with plenty of water
• Avoiding dietary fat, chocolate, caffeine, and peppermint because they may cause lower esophageal pressure
• Avoiding alcohol and tobacco

Medications to relieve symptoms and control gastroesophageal reflux include antacids after meals and at bedtime, histamine H2 receptor blockers, proton pump inhibitors, cholinergic agents, and promotility agents.

Surgery to remove a portion of the esophagus may be recommended, if a biopsy shows the type of cellular changes that tend to lead to cancer (these changes are called dysplasia).

Photodynamic therapy (PDT) is a newly approved option that may allow you to avoid surgery. PDT involves the use of a special laser device, called an esophageal balloon, along with a drug called Photofrin. Together, the laser balloon and medication lead to destruction of the abnormal cells lining the esophagus, without affecting the normal tissue.

Expectations (prognosis):

An increased risk of esophageal cancer is present. Follow-up endoscopy to look for dysplasia or cancer is often advised.

Complications:

• Esophageal dysplasia
• Esophageal cancer

Calling your health care provider:

Call your health care provider if heartburn persists for longer than a few days, or you have pain or difficulty swallowing.

Call your provider if symptoms worsen, do not improve with treatment, or if new symptoms develop in a person with Barrett's esophagus.

• Review Date: 10/13/2006
• Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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