Millions of people suffer from disorders of the esophagus, the tube that connects the throat to the stomach. The walls of the esophagus propel food to the stomach by rhythmic waves of muscular contractions called peristalsis. Esophageal disorders occur most frequently due to structural abnormalities, motility (movement) disorders, inflammatory disorders, and occasionally malignancies that disrupt this process and can cause severe pain and illness.
One of the most common problems with the esophagus is gastroesophageal reflux disease (GERD), commonly called heartburn. This occurs when a band of muscle at the end of the esophagus (the lower esophageal sphincter, or LES) does not close properly, allowing acidic stomach contents to flow backward into the esophagus and cause irritation and sometimes pain. In a small percentage of patients, chronic GERD can cause a condition called Barrett’s esophagus. In Barrett’s esophagus the tissue lining the esophagus is damaged and replaced by tissue that resembles intestinal tissue – this is called Intestinal Metaplasia.
Barrett’s esophagus facts
- Approximately 3.3 million adults in the United States suffer from Barrett’s.1,2
- Men develop Barrett’s twice as often as women
- The average age of diagnosis is around 50 years of age.
- Only about half of Barrett’s esophagus patients report GERD symptoms, so symptoms of heartburn are not a reliable predictor of the condition.
- A Barrett’s esophagus diagnosis can be concerning because it increases the risk of developing esophageal cancer. At 0.5% per year, the risk of esophageal cancer is low, but Barrett’s patients are more likely to develop esophageal cancer than the general population.3
Your doctor may recommend monitoring of the esophagus with an endoscope through periodic exams (esophagogastroduodenoscopy, or EGD) to look for Barrett’s and test (biopsy) for dysplasia, or early signs that cells could become cancerous. If either Barrett’s or precancerous cells are found, they can usually be removed or ablated through several methods including spray cryotherapy. Spray cryotherapy is intended to be used as a cryosurgical tool for the destruction of unwanted tissue.
The incidence of esophageal cancer has risen about six-fold in the U.S. in the past three decades – a rate faster than that of breast cancer, prostate cancer, or melanoma.4,5 Early diagnosis and intervention are very important. Talk with your doctor if you feel that you have symptoms of esophageal disease, including chronic GERD, painful swallowing (odynophagia) or difficulty swallowing (dysphagia).
For additional information:
1. Reid B.J and Weinstein W. M. Barrett’s esophagus and adenocarcinoma. Gastroenterology Clinics of North America 1987; 38: 477-492.
2. “What Are the Key Statistics about Cancer of the Esophagus?” Cancer.org. 2006. American Cancer Society. Accessed October 2007.
3. Sharma VK, Wang KK, Overholt BF, et al. Balloon-based, circumferential, endoscopic radiofrequency ablation of Barrett’s esophagus: 1-year follow-up of 100 patients. Gastrointest Endosc 2007; 65:185-194.
4. “Fastest Rising Form of Cancer in the U.S.” Webmd.com. 2005. WebMD. www.webmd.com/cancer/news/20050118/esophageal-cancer-on-rise Accessed October 2007.
5. 16 Heiko Pohl and H.G. Welch. The role of over diagnosis and reclassification in the Marked Increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005: 97: 142-146.