Named after Norman Barrett who first described the disease in 1950, Barrett’s esophagus (BE) develops because of chronic exposure to stomach acid as a result of gastroesophageal reflux (GERD) which propels stomach acid up into the esophagus. Over time, cellular changes can occur near the juncture of the esophagus and the stomach which are pre-cancerous. Without treatment, cancer may occur.

Not all people who have GERD develop BE. In fact, about 25% of people who develop esophageal cancer have had no obvious signs of reflux. In addition, symptom severity does not correlate with BE. This makes identifying those at risk for BE more difficult. None-the-less, we do know that white and Hispanic men are more likely to develop BE, and that advancing age, obesity and smoking are contributing factors. 

Screening guidelines by the American College of Gastroenterology recommend that those with chronic GERD symptoms (defined as those experiencing reflux 3x/wk) should have an upper endoscopy. Certainly anyone who has difficulty swallowing, pain upon swallowing,  experiences bleeding or unexplained weight loss, needs to have an immediate referral. 

Overall, managing GERD symptoms is key and medication includes proton-pump inhibitors and H2 receptor blockers. Be sure to see your provider if you suffer from GERD for further evaluation.

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