Barrett's esophagus is a chronic condition in which the protective cells that line the esophagus undergo major changes. Cells are damaged by stomach acids that regurgitate up the esophagus in a disorder called gastroesophageal reflux disease (GERD). In most cases, Barrett's esophagus can be treated by eliminating the underlying causes of GERD, which may involve dietary restrictions, lifestyle changes, and daily medications. More aggressive Barrett's esophagus treatment in the form of cell ablation, photodynamic therapy (PDT), or surgery may be necessary in an advanced case in which symptoms are severe and there is a possibility of developing esophageal cancer.
After a doctor confirms cell changes in the esophagus are related to GERD, he or she can explain different Barrett's esophagus treatment options in detail. The physician may suggest making changes to diet and exercise habits if the condition is mild. Fitness is important for esophageal health, so patients are usually instructed to establish regular exercise routines, quit smoking, and eat healthier foods in smaller portions. Avoiding foods and drinks that trigger GERD symptoms, such as alcohol, spicy dishes, and citrus fruits, helps many people avoid heartburn flares. In addition, over-the-counter and prescription antacids are useful in controlling GERD and preventing Barrett's esophagus from worsening.
A person who has severe, frequent GERD symptoms but relatively minor Barrett's esophagus problems may be a good candidate for fundoplication surgery. During the procedure, the upper neck of the stomach is wrapped around the base of the esophagus to strengthen the sphincter between the two. GERD surgery helps to prevent stomach acids from backing up in the throat, thereby giving damaged esophageal tissue cells time to heal. While it is not a direct Barrett's esophagus treatment, the procedure does lead to partial or complete recovery in a large number of patients.
If conservative Barrett's esophagus treatment and fundoplication surgery fail to relieve problems, a patient may need to undergo additional procedures. Small, well-defined patches of damaged tissue can often be removed with heat ablation, PDT, or surgical excision. Ablation involves exposing esophageal cells to a high-energy heat source until they burn and die. During PDT procedures, a light-sensitive chemical injected into the body reacts violently when a bright light is put down the throat, leading to cell death. Finally, an endoscope and a precision scalpel may be used to manually scrape away cells from the surface of the esophagus.
Esophagectomy, or surgical removal of the esophagus, is only needed as part of Barrett's esophagus treatment if the cells look like they may soon become cancerous. During the procedure, most of the esophagus is removed, and the stomach is tied to the remaining tissue. Esophagectomy can be risky, and patients generally have long, uncomfortable recovery periods, but the benefits of preventing life-threatening cancer far outweigh the risks in most cases.