Barrett’s Esophagus is a condition whereby the lower portion of the esophagus is burned by chronic acid reflux. This condition then allows the stomach lining to replace the burned esophageal lining. Because of this alteration there is a very small chance of cancer occurring in that area. This risk has probably been over estimated in the past, causing a great deal of worry in the lay population. We have, however, studied this issue and presented our 12 year findings at the National Gastrointestinal Society meetings of 11/03.
We found a 0.5% annual incidence of esophageal cancer in patients with Barrett’s Esophagus. More importantly only those patients with long lengths of the abnormal lining developed cancer. Patients with very short lengths of Barrett’s tissue did not go on to cancer in our studies. However, since there are no certainties when dealing with the human condition, we continue to recommend surveillance of the esophagus with gastroscopy every 3 years for patients with a long Barrett’s Esophagus and every 5 years when they have a short Barrett’s. Chronic use of a proton pump inhibitor, i.e. Prilosec, Nexium, Prevacid, Protonix, Aciphex) is recommended. This may reduce the risk of cancer even further. We have not found that anti-reflux surgery has ever led to regression (cure) of Barrett’s Esophagus, nor has it been as effective in controlling acid reflux as medical therapy (in general).