Barrett's Esophagus

Barrett's esophagus is a condition in which the tissue that lines the esophagus – the muscular tube that runs from the mouth to the stomach – is replaced with tissue similar to that which lines the intestines. This tissue is associated with the development of esophageal cancer, or esophageal adenocarcinoma.

UT Southwestern’s team of interventional gastroenterologists perform the latest techniques to evaluate and in some cases remove the Barrett’s esophagus lining that has developed, including esophageal mucosal resection, esophageal submucosal dissection, radiofrequency ablation, and cryotherapy.

Our highly skilled thoracic surgeons also perform leading-edge procedures to reduce gastroesophageal reflux and, if necessary, remove the esophagus when esophageal cancer is present. In most cases, these procedures can be performed minimally invasively or robotically, leading to a better patient experience.

Our surgeons work closely with UT Southwestern’s gastroenterologists, oncologists, and pathologists to deliver comprehensive care – all in one location, and usually on the same day.

Risk Factors

People with chronic acid reflux (gastroesophageal reflux disease, or GERD) are more likely to develop Barrett's esophagus, and those with Barrett's esophagus are at slightly higher risk for developing esophageal adenocarcinoma, the most common form of esophageal cancer.

Symptoms

Symptoms related to Barrett's esophagus are the same as those of gastroesophageal reflux disease and may include:

• Heartburn or a burning sensation under the breastbone
• Having a bitter taste in the mouth
• Food getting stuck in the chest
• Stomach acid flowing backward into the throat or mouth

Diagnosis

A gastroenterologist makes the diagnosis of Barrett's esophagus using an endoscopic evaluation and biopsy of the esophageal lining. The biopsy results are reviewed by a specialized gastrointestinal pathologist, who determines whether a premalignant lesion (dysplasia) or cancer is present.

Treatments

Our highly skilled team of thoracic surgeons and gastroenterologists perform cutting-edge techniques to evaluate – and in some cases remove – the Barrett's esophagus lining. We offer the following treatments:

• Antireflux surgery: To prevent further injury to the esophagus
• Cryotherapy: Uses very cold liquid to freeze the lining of the esophagus, allowing the normal lining to return.
• Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD): Minimally invasive procedures that remove large areas of the lining of the esophagus through an endoscope, preventing progression to cancer and allowing the normal lining of the esophagus to return. For early superficial cancers, they may be as effective as surgery.
• Medications: To reduce reflux and inflammation (they do not cure Barrett's esophagus)
• Minimally invasive or robotic esophagectomy: Used when the Barrett's changes have become an invasive cancer
• Radiofrequency ablation: An endoscopic technique in which diseased tissue is exposed to heat energy and destroyed, allowing the normal lining to return 
• Surveillance for Barrett's esophagus: To determine if there is a premalignant lesion or early cancer

Related Conditions

Our Thoracic Surgery team treats the full range of thoracic (chest) conditions. These include:

• Benign (noncancerous) esophageal tumors, including esophageal nodules and masses, including leiomyoma and gastrointestinal stromal tumors (GISTs)
• Esophageal cancer
• Esophageal motility disorders, including achalasia 
• Esophageal perforation
• Esophageal reflux, also known as gastroesophageal reflux disease (GERD)
• Esophageal strictures or narrowing
• Hiatal hernia, including giant hiatal hernia with gastric volvulus (twisted stomach) and paraesophageal hiatal hernia (a specific type of hernia that usually requires repair)
• Tracheoesophageal fistulas

Clinical Trials

In addition to standard treatments for Barrett's esophagus, UT Southwestern gives patients access to the most promising new therapies through clinical trials. Talk with your doctor to see if a clinical trial may be right for you.