Conditions & Treatments

Barrett's Esophagus

Barrett's esophagus is a condition in which normal cells that line the esophagus turn into cells not usually found in humans called “specialized columnar cells.”

Barrett's Esophagus

Illustration of the anatomy of the digestive system, adult
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What is Barrett's esophagus?

Barrett's esophagus is a condition in which normal cells that line the esophagus, called squamous cells, turn into cells not usually found in humans, called specialized columnar cells. This process is called intestinal metaplasia because the specialized columnar cells are similar to the lining of the intestine. Damage to the lining of the esophagus causes the cells to change. Less than 1 percent of people with this condition develop cancer of the esophagus. However, having Barrett's esophagus may increase the risk of developing esophageal cancer.

What causes Barrett's esophagus?

Barrett's esophagus develops in some people who have chronic gastroesophageal reflux disease (GERD) or esophagitis (inflammation of the esophagus). It is believed that damage to the lining of the esophagus, caused by these conditions, causes these abnormal cell changes.

Illustration demonstrating gastroesophageal reflux
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People who have had long-standing heartburn are at risk for Barrett's esophagus and should discuss this with their doctor.

What are the symptoms of Barrett's esophagus?

The following are the most common symptoms of Barrett's esophagus. However, each individual may experience symptoms differently. Symptoms may include:

  • Waking in the night because of heartburn pain

  • Vomiting

  • Difficulty in swallowing

  • Blood in vomit or stool

Some people with this condition may be asymptomatic. The symptoms of Barrett's esophagus may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

Illustration of an esophagogastroduodenoscopy procedure
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How is Barrett's esophagus diagnosed?

In addition to physical examination, the doctor will perform an endoscopy, during which a long, thin tube, called an endoscope, is inserted through the mouth and gently guided into the esophagus. This contains instruments that allow the doctor to see the lining of the esophagus and remove a small tissue sample (a biopsy), which is examined in a laboratory to determine whether the normal squamous cells have been replaced with columnar cells. If a person complains of trouble swallowing, an upper GI barium study may be helpful in identifying areas of narrowing called strictures.

Treatment for Barrett's esophagus

Specific treatment for Barrett's esophagus will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of this disease

  • Your opinion or preference

Currently, there is no cure for Barrett's esophagus. Once the cells in the esophageal lining have been replaced by columnar cells, they will not revert back to normal. Thus, treatment is aimed at preventing further damage from occurring by stopping acid reflux from the stomach. Treatment may include:

  • Medication. Medications such as H2 receptor antagonists and proton pump inhibitors, which reduce the amount of acid produced in the stomach, may be prescribed by your doctor.

  • Surgery. Surgery to remove damaged tissue or a section of the esophagus may be necessary. Known as fundoplication, part of the esophagus is removed and the remaining section is attached to the stomach.

  • Dilation procedure. If strictures (narrowing of the esophagus) are present, caused when the damaged lining of the esophagus becomes thick and hardened, a procedure called dilation is used. During dilation, an instrument gently stretches the strictures and expands the opening of the esophagus.

Treatment Programs

Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:

Digestive Healthcare Center

  • Barrett’s Esophagus Treatment Center
    The multidisciplinary Barrett’s Esophagus Treatment Center at Massachusetts General Hospital provides comprehensive care, from endoscopic diagnosis to minimally invasive treatment, for Barrett’s esophagus.
  • Swallowing and Heartburn Center
    The Swallowing and Heartburn Center at the Massachusetts General Hospital Digestive Healthcare Center provides both primary treatment and second opinion evaluations for throat, esophagus and stomach disorders.

  • Adult Medicine Imaging
    The Adult Medicine Imaging Program at Massachusetts General Hospital Imaging offers a wide range of diagnostic exams and minimally invasive, image-guided treatments, all provided using leading-edge equipment and interpreted by specialty-trained radiologists.

  • Swallowing and Heartburn Program
    The Swallowing and Heartburn Program at the Gastroenterology Division of Massachusetts General Hospital provides both primary treatment and second opinion evaluations for disorders of the esophagus and stomach.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Barrett's esophagus: aggressive treatment helps prevent progression to cancer

Physicians can help stem the rising incidence of gastroesophageal cancers by aggressively treating patients with gastroesophageal reflux (GERD) and Barrett's esophagus.

Frequently asked questions: LINX® system

David Rattner, MD, chief of the Division of Gastrointestinal and General Surgery at the Mass General Digestive Healthcare Center, answers frequently asked questions (FAQ) about the LINX® Reflux Management System, a new treatment option for gastroesophageal reflux disease (GERD).

Magnetic esophageal sphincter device benefits patients with GERD

The New England Journal of Medicine publishes the three-year results of a study of the safety and effectiveness of a new device for treatment of gastroesophageal reflux disease (GERD).

Getting Back to Active: Bob’s Story

Bob Hazelton lived with chronic acid reflux for years and was diagnosed with esophageal cancer in 2011. After his surgical team at Massachusetts General Hospital performed a minimally invasive esophagectomy, Bob has a healthy esophagus and is getting back to his active lifestyle.

Preview clip of Digestive Healthcare Center CME program

David Ryan, MD, explains the reasons for the current epidemic of esophageal cancer.

Preview clip of Digestive Healthcare Center CME program

David Rattner, MD, explains the management of gastroesophageal reflux, including indications for medical, endoscopy and surgical interventions to control this condition.

Preview clip of Digestive Healthcare Center CME program

Christopher Morse, MD, reviews minimally invasive treatments for esophageal cancer, including esophageal resections. Please note that this video contains images from a real procedure and may cause discomfort for some viewers.

David Rattner, MD, explains how screenings can prevent esophageal cancer

David Rattner, MD, Co-Chief of the Massachusetts General Hospital Digestive Healthcare Center describes how chronic heartburn can lead to other serious conditions, who is most at risk and how Barrett's esophagus and esophageal cancer can be diagnosed and treated.

Innovative care at the Digestive Healthcare Center

Learn more about the latest treatment options for this condition at the Digestive Healthcare Center