Barrett's Esophagus

What is Barrett's esophagus?

Barrett's esophagus occurs when the normal lining of the esophagus (the tube that connects the mouth to the stomach) is replaced with tissue similar to that found in the intestinal lining. It can result from chronic esophageal inflammation (esophagitis), such as that caused by gastroesophageal reflux disease (GERD). Because Barrett's esophagus can increase the risk of esophageal cancer later in life, it's important that children with esophagitis receive routine evaluation and screening for the condition.

What are the symptoms of Barrett's esophagus?

Barrett's esophagus doesn't cause any symptoms itself. However, people with Barrett's esophagus often also have GERD, which can have symptoms such as heartburn, belching, coughing, choking and wheezing. GERD may also not have any symptoms.

What causes Barrett's esophagus?

Although the exact cause of Barrett's esophagus isn't clear, it seems to be related to chronic esophageal inflammation, or esophagitis. The acid or bile reflux associated with GERD can lead to chronic inflammation. GERD can be found in conditions such as esophageal atresia, ingestion of corrosive substances (such as certain household cleaners), eosinophilic esophagitis and infection.

Over time, this inflammation appears to damage the cells in the lining of the esophagus. Instead of healing, these cells grow to resemble the cells that line the intestines. Barrett's esophagus has been linked to an increased risk of esophageal cancer.

How we care for Barrett's esophagus

The clinicians at Boston Children's Hospital take a proactive approach to Barrett's esophagus. Outcomes from Boston Children's suggest that a good percentage of esophageal atresia patients have biopsy-proven esophagitis, even if they don't have any symptoms. For this reason, we recommend that every child who has been treated for esophageal atresia be routinely screened for esophagitis through endoscopy.