DEAR DR. GOTT:
I recently had an endoscopy and was diagnosed with Barrett’s esophagus. What is the best treatment? Is surgery an option?
I read your articles every day and save many of them. Keep up the good work.
DEAR READER:
Barrett’s esophagus is a condition in which the lining of the esophagus is replaced by tissue similar to that of the intestine.
The cause of Barrett’s is unknown. It is three to five times more likely to occur in people with gastroesophageal reflux disease (GERD). The condition itself, however, has no signs or symptoms. Men are affected nearly twice as often as women and Caucasian men are at the top of the list.
Some individuals (less than one percent) with the condition can develop a rare but deadly type of esophageal cancer. The type of cancer associated with Barrett’s esophagus (esophageal adenocarcinoma) is difficult to treat because it is often not found until in the late stages. For this reason, regular examinations, endoscopies and biopsies are necessary. Biopsies can often show precancerous changes which allow for treatment that may prevent further change in the tissue.
Without symptoms, many physicians recommend adults age 40 and older who have had GERD for a number of years undergo endoscopy and biopsy. These are the only tests available for the diagnosis of the condition.
There are a few treatments available for mild to moderate precancerous changes. Photodynamic therapy uses a light-sensitizing agent and a laser to kill the abnormal cells. Endoscopic Mucosal Resection involves lifting the Barrett’s lining and then cutting it off. On occasion, both procedures are performed together. A final option is surgical removal of most of the esophagus. This is only done on individuals with major precancerous changes or full-blown esophageal cancer.
I urge you to return to your gastroenterologist for an explanation of the disorder. He or she is your best resource for information and is the most familiar with your individual case.
If you would like to learn more about Barrett’s esophagus, I recommend you go to the National Digestive Diseases Information Clearinghouse’s website http://digestive.niddk.nih.gov/ddiseases/pubs/barretts or request information by writing to them at 2 Information Way, Bethesda, MD 20892-3576 or by phoning 1-800-891-5389.
To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
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