The simple answer to this question is that at this time, short of surgically removing the esophagus, there is no guaranteed treatment to prevent esophageal cancer in Barrett’s esophagus. But we do have treatments that are helpful and the risk of developing cancer is very low.
Barrett’s esophagus occurs when a different cell type replaces the normal cells lining the lower esophagus. Usually this is caused by stomach acid backing up into the esophagus, gastroesphageal reflux disease (GERD). Twenty percent or more of adults have chronic GERD and of these 10% to 15% will have Barrett's esophagus. If you have GERD, it's important to know if you also have Barrett's esophagus. That's because Barrett's esophagus can later turn into pre-cancer or cancer of the esophagus. Adults with chronic severe reflux have over a 50% chance of having Barrett's esophagus. The good news; however, is that recent studies show that the risk of developing cancer from Barrett’s is low. Every year, only 0.12 % of the patients with Barrett’s or about one in 860 people develop esophageal cancer.
Barrett’s is diagnosed by an upper endoscopy. During an upper endoscopy, a doctor puts a tube into your mouth and down into your esophagus and takes samples. An endoscopy is recommended for patients with Barrett’s and no dysplasia every 3 to 5 years.
The majority of patients with Barrett’s have no evidence of dysplasia. This means that although the cells lining the esophagus have changed to a different cell type, they are still healthy. A small proportion of people will have dysplasia or cancer.
For the majority of patients with Barrett’s and no evidence of dysplasia, the recommended treatment is the use of proton pump inhibitors, PPIs. Some examples of these drugs are available over the counter, omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix), but the doses recommended for Barrett’s are prescription strength and often given twice daily. Treatment does not usually cure Barrett's, but it keeps it from getting worse. PPIs have not been proven to prevent esophageal cancer in Barrett’s.
Other treatments for Barrett’s include general recommendations for GERD such as:
- Avoid alcohol, fatty foods, caffeine drinks and other foods or beverages that can make GERD worse.
- Don’t eat a large meal before bed.
- Raise the head of the bed when you sleep.
There are other treatments such as radiofrequency ablation of the esophagus or anti-reflux surgery that have been used in some patients with Barrett’s and no dysplasia, but this is not generally recommended. Some studies have suggested that aspirin and other similar drugs like ibuprofen (Advil) might reduce the risk of esophageal cancer, but this is not currently recommended.
If you have Barrett’s, talk to your doctor about your symptoms and concerns. Your doctor will be able to help you weigh your risk of developing dysplasia or cancer and help you design the best strategy for your care.
This answer should not be considered medical advice...This answer should not be considered medical advice and should not take the place of a doctor’s visit. Please see the bottom of the page for more information or visit our Terms and Conditions.
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