Barrett’s Esophagus

Barrett’s Esophagus Care at UVM Health

Barrett’s esophagus is a condition that affects the lower part of the esophagus, where it meets the stomach. The cells lining that area take on characteristics of a different type of cell that lines the intestine. This change in cell type is known as metaplasia.

Barrett’s esophagus may increase your risk of developing esophageal cancer. Although this outcome is relatively rare, accurate diagnosis, close monitoring and effective treatment are essential for people with Barrett’s esophagus.

Why Choose UVM Health?

At University of Vermont Health, our gastroenterologists follow the latest guidelines for evidence-based Barrett’s esophagus care. We work with you to help you understand your individual condition, cancer risk and treatment options. At every step, our team is by your side with guidance, compassion and support.

As a leading gastroenterology program in the region, we offer:

Experienced specialists: Across UVM Health, our experienced gastroenterologists provide skilled diagnosis, management and treatment of Barrett’s esophagus. As part of a health system anchored by an academic medical center, many of our physicians are active researchers.
Leading-edge treatments: We offer endoscopic procedures to remove Barrett’s esophagus tissue, including radiofrequency ablation therapy and endoscopic mucosal resection. These highly specialized procedures are the most advanced available and are not offered widely in the region.
World-class cancer care: Rarely, Barrett’s esophagus develops into esophageal cancer. In this case, our multidisciplinary team of gastrointestinal (GI) cancer experts is here for you. We provide patient-centered care and comprehensive, advanced treatments and support for you and your family.

What Causes Barrett’s Esophagus?

The exact cause of Barrett’s esophagus is unknown. Researchers think it is related to the reflux of stomach acid into your esophagus. Most people who develop Barrett’s esophagus have gastroesophageal reflux disease (GERD). Barrett’s esophagus can also run in families.

In some cases, the cells lining the esophagus become precancerous (dysplasia). Barrett’s esophagus with dysplasia typically requires more advanced monitoring and treatment to prevent cancer.

Diagnosing Barrett’s Esophagus

Tests we use to diagnose Barrett’s esophagus include:

Upper GI tract endoscopy: Your provider inserts a thin, lighted tube called an endoscope into your esophagus to look for abnormal areas of tissue.
Biopsy: A biopsy is a small sample of tissue collected during an endoscopy using small tools passed through the endoscope. Your provider sends the tissue sample to a laboratory for analysis.

An increase in esophageal cancer rates has led to a greater emphasis on detecting Barrett’s esophagus early. Your doctor can help you determine whether an endoscopy is right for you.

The main symptom of Barrett’s esophagus is GERD, which is a very common condition. But not all people with GERD need an endoscopy. The current guidelines recommend screening for Barrett’s esophagus if you have chronic GERD (symptoms for five years or more) and one or more other risk factors, such as:

Age older than 50
Family history of Barrett’s esophagus
Male sex
Overweight or obesity
Smoking

Barrett’s Esophagus Treatment

Physicians and patients across the region turn to us for our expertise and patient-centered approach to Barrett’s esophagus treatment. Our providers work with you to develop a personalized care plan that meets your needs and treatment goals. Your plan may include:

Lifestyle Changes

Lifestyle changes can help reduce GERD and Barrett’s esophagus symptoms. Your provider may suggest the following:

Avoid lying down on a full stomach
Maintain a healthy weight
Stop smoking

Medications

Proton pump inhibitors are a common treatment for Barrett’s esophagus. These medications reduce stomach acid production, preventing further damage to your esophagus.

Monitoring

If you have Barrett’s esophagus without dysplasia, your provider will monitor you for any changes in your condition. The current guidelines advise an upper endoscopy and biopsy every three to five years.

For Barrett’s esophagus with dysplasia, we typically recommend more frequent monitoring or a minimally invasive procedure.

Minimally Invasive Procedures

Since Barrett’s esophagus with dysplasia has a greater likelihood of developing into esophageal cancer, our treatment approach is often to remove the diseased tissue. Most of the time we use minimally invasive endoscopic procedures. Because these procedures do not require open incisions, they usually have a faster recovery time with less pain and fewer complications.

Ablation Therapy

Radiofrequency ablation is the most common type of ablation treatment for Barrett’s esophagus. It uses radio waves to generate electrical impulses that heat diseased tissue and destroy it. We apply the electrical impulses to the top tissue layer. Different electrode shapes help us target the abnormal areas precisely. If you have a large amount of Barrett’s tissue, you may need several radiofrequency ablation treatments.

Radiofrequency is an effective treatment for flat lesions and low-grade dysplasia. It usually eliminates the dysplasia and Barrett’s tissue. Studies suggest the risk of cancer after radiofrequency ablation treatment is less than one percent.

Cryotherapy is another type of ablation therapy. It involves applying a liquid nitrogen solution to freeze and destroy the Barrett’s tissue.

Barrett’s esophagus can return after ablation therapy. Our specialists recommend routine monitoring to find recurrences early and treat them.

Endoscopic Mucosal Resection

We use endoscopic mucosal resection for more advanced dysplasia and when there are raised nodules. In the procedure your provider:

Suctions a small area of the esophagus into a cap on the endoscope
Seals the suctioned area with a rubber band to create a pouch
Cuts off and removes the pouch of tissue

With each endoscopic mucosal resection, we can treat an area about the size of a postage stamp. For larger sections, we do multiple resections during a single procedure.

Surgery

Surgery is rare for Barrett’s esophagus. We typically consider surgery only when:

Cancer penetrates deep into the esophagus wall
Minimally invasive treatments are not effective

Wellness & Prevention

Evidence shows that proactive health care focused on preventing illness leads to better outcomes. We're here to help you live a healthier, happier life. We offer wellness and prevention services to empower you to take control of your health.