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Doctors at Mayo Clinic have an international reputation for their skill in diagnosing and treating Barrett's esophagus. Each year, more than 2,000 patients are evaluated and treated for this condition at Mayo Clinic. Treatments available at Mayo include endoscopic management, such as photodynamic therapy (PDT) and endoscopic mucosal resection (EMR). Mayo Clinic has an active research program for Barrett's esophagus, including a Barrett's family registry. Mayo Clinic in Rochester, Minn., ranked No. 1 among U.S. hospitals in the specialty of digestive disorders in the 2007 U.S. News Best Hospitals ranking.
Dr. Romero and other Mayo doctors discuss treatment of Barrett's esophagus.
Mayo offers the latest in screening and diagnostic services for Barrett's esophagus. Patients with longstanding reflux should be examined with endoscopy to look for the presence of Barrett's. Once diagnosed with Barrett's, patients should undergo periodic endoscopic examination and biopsy (tissue sampling) to detect developing dysplasia and cancer at an early and curable stage. Read more about diagnosis of Barrett's esophagus.
The best treatment strategy for Barrett's esophagus is prevention. Once the condition develops, endoscopy is used to monitor for the development of dysplasia and cancer. When these pre-cancerous changes are detected, invasive cancer can develop with lethal rapidity. So when cancerous changes are found, the lower esophagus must either be surgically removed or the lining of the esophagus must be destroyed using endoscopy techniques such as photodynamic therapy. Read more about treatment of Barrett's esophagus.
Barrett's esophagus is an important consequence of long-standing acid reflux disease because patients with Barrett's are at risk for developing cancer of the esophagus. The acid reflux stimulates changes in the lining of the esophagus (the food tube connecting the mouth to the stomach), so that it resembles the lining of the intestines. This alteration (or metaplasia) represents a precancerous condition.
Barrett's esophagus is uncommon. About 5 percent of people with gastroesophageal reflux disease (GERD) develop Barrett's esophagus. But once diagnosed, there is a 30- to 125-fold increased risk of developing esophageal cancer; an estimated 0.5 percent of Barrett's patients develop cancer each year. The cancer can spread to lymph nodes and other organs. Esophageal cancer arising from Barrett's esophagus is the second fastest growing type of cancer in the United States.
Patients with Barrett's esophagus frequently are found to have severe gastroesophageal reflux disease. This observation has led to the widely accepted belief that Barrett's esophagus develops as a result of long-standing reflux esophagitis. It is not known whether it is gastric acid, gastric or pancreatic proteolytic enzymes, bile or some other caustic substance that is responsible for the changes leading to Barrett's esophagus.
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