Barrett Esophagus

Barrett Esophagus is a condition affecting the esophagus, the tube that carries food from the mouth to the stomach. It occurs when the normal lining of the esophagus changes to a type of lining similar to that found in the intestines, often due to long-term damage from stomach acid. This change is called intestinal metaplasia and happens because of chronic acid reflux or gastroesophageal reflux disease (GERD). The condition can increase the risk of developing a type of esophageal cancer called adenocarcinoma. People with Barrett Esophagus may not have symptoms different from GERD, but the condition is important to monitor because of its potential complications.

Barrett Esophagus is defined by the replacement of the normal stratified squamous epithelium of the distal esophagus with specialized intestinal metaplasia, characterized by the presence of goblet cells. This metaplastic change is primarily caused by chronic exposure to gastric acid and bile reflux due to gastroesophageal reflux disease (GERD). The condition is clinically significant because it is a recognized precursor lesion for esophageal adenocarcinoma, increasing cancer risk by 30 to 125 times compared to the general population. Histologically, the presence of goblet cells on biopsy confirms the diagnosis. The pathogenesis involves chronic inflammation leading to epithelial injury and subsequent metaplastic adaptation. Surveillance and early detection of dysplasia are critical for preventing progression to malignancy.