The acid in your stomach is pretty potent. It breaks down chunks of steak, fibrous veggies, and even chewing gum if it has to. Your stomach lining is meant to handle this intense level of acidity, but if its acid comes into contact with other body parts, it can do some damage.
At Northside Gastroenterology Associates in Cypress and Houston, Texas, Dr. Ayub Hussein specializes in all forms of acid reflux and the complications it causes. One of those complications, called Barrett’s esophagus, can lead to chronic symptoms, difficulty swallowing, pain, and even cancer. Here, Dr. Hussein takes a closer look at this progressive condition.
Before we dive into Barrett’s esophagus, let’s take a look at your anatomy and what acid can do to it.
Your esophagus is the long tube that delivers food and liquid from your throat to your stomach. At the bottom end of the tube, there’s a one-way valve called the lower esophageal sphincter (LES) that keeps food and stomach acid from creeping back up. Normally, the LES is tightly closed — it should only open when you swallow, so food can pass through to your stomach.
When you have an occasional bout of heartburn, it’s an indication that a bit of your stomach acid has crept up past your LES and into your esophagus, which is located in your chest area. So what’s commonly called heartburn is actually “esophagus burn.” When this is mild and happens once or twice a week, it’s called acid reflux, and when it’s severe and even more frequent, it’s called gastroesophageal reflux (GERD).
There are many different causes of acid reflux and GERD, but the effect is the same: stomach acid flows upward into your esophagus. Over time, your stomach acid does what acids do — it destroys tissue.
If your esophagus lining has been damaged by months or years of GERD, you have a condition called Barrett’s esophagus. If you could see inside your esophagus, you’d see a thickened, red lining indicating a foundational change in the tissue.
Although chronic GERD is a common cause of Barrett’s esophagus, about 50% of those who develop this condition never experience any acid reflux at all, or may have had GERD in the past. This means that even if you don’t have GERD, it’s important to get checked for Barrett’s esophagus if you’re in a high-risk group, which includes:
Barrett’s esophagus alone doesn’t typically present any symptoms. The signs that may indicate you have Barrett’s esophagus or a condition that puts you in danger of developing it, include the same symptoms common to acid reflux and GERD:
To diagnose Barrett’s esophagus, Dr. Hussein performs an upper endoscopy to get a closer look at your esophagus. He may also take a biopsy to test the lining tissue to confirm the diagnosis.
Dr. Hussein’s approach to your treatment depends largely on your symptoms and the condition of your esophagus. If you have a mild case, the primary focus is treating the root cause of the problem, which is the GERD.
The most conservative treatments include losing weight, modifying your diet, and elevating your head when you sleep. Dr. Hussein may also prescribe medication to reduce acid or to promote healthy esophageal motility by applying pressure to your LES. Surgery may become necessary if these treatments don’t resolve the problem.
Barrett’s esophagus may increase your risk of developing cancer. If your esophageal lining looks suspicious, Dr. Hussein takes a tissue sample to check for cancerous cells. Because Barrett’s esophagus develops very methodically, we monitor you closely over the next few months and years to watch for changing status.
If your tissue sample shows low-grade dysplasia (the presence of some abnormal cells), we check you every six months to watch for changes. If you have high-grade dysplasia (significant change in your esophageal lining), you’re at a higher risk for cancer and may need treatments, such as radiofrequency ablation, cryotherapy, or surgery.
If you have GERD, had GERD for some time but no longer experience the symptoms, or you’re in one of the high-risk groups for Barrett’s esophagus, schedule an appointment to meet with Dr. Hussein and find out for sure what’s going on in your esophagus. Book online or call us today.