Esophageal Diseases

Barrett's Esophagus

Advanced Testing and Treatment

Barrett's esophagus is a precancerous change in the lining of the esophagus that some patients develop in response to reflux. Sometimes this precancerous tissue can turn into esophageal cancer. The specialists of NewYork-Presbyterian’s esophageal disorders programs treat one of the largest volumes of individuals with Barrett’s esophagus in the United States. Our state-of-the-art facilities offer comprehensive diagnostic testing and endoscopic and surgical treatments. We aim to relieve your symptoms related to reflux and prevent Barrett’s from progressing to esophageal cancer.

What causes Barrett's esophagus?

Long-standing acid reflux (gastroesophageal reflux disease or GERD) is thought to be the key cause of Barrett's esophagus, but some patients with Barrett’s have no symptoms of reflux.

Barrett's Esophagus Signs & Symptoms

If you have Barrett's esophagus, you may experience the same symptoms associated with chronic GERD, such as:

• Heartburn
• Regurgitation of food
• Chest pain
• Trouble swallowing

Many patients with Barrett’s esophagus have no symptoms at all; Barrett's tissue changes are not typically felt, but rather need to be confirmed through diagnostic testing.

Making an Accurate Diagnosis

The most effective care for Barrett’s esophagus begins with an accurate diagnosis. To determine if you have this disorder and to assess its severity, our doctors use:

• High-definition white light endoscopy. By inspecting the inside of your esophagus using a flexible tube with a camera at its tip, your gastroenterologist can see and remove abnormal tissue to determine if you have Barrett’s esophagus.
• Narrow band imaging (NBI) uses a special system to capture high-resolution images of the inner surface of your esophagus. Using light of different wavelengths, your doctor can see fine features of the tissue in your esophagus.
• Chromoendoscopy. This technique uses dyes to detect areas of the esophagus with abnormal tissue that can targeted for testing or treatment.
• Confocal/laser endomicroscopy. This advanced imaging technique permits high-resolution assessment of the cells of the esophageal mucosa (top-most lining) and can be used to perform targeted biopsies of abnormal tissue thickening.

Our Approach to Care

The care of people with Barrett’s esophagus is optimized using a team of specialists. Your team at NYP will include gastroenterologists, interventional endoscopists, surgeons, radiologists, nutritionists, nurses, and others with the clinical expertise, compassion, and skills to provide the highest quality care. Our specialists work together to provide you with coordinated, individualized care using the latest technologies.

Barrett's Esophagus Care

Our goal is to remove or destroy precancerous changes of the esophagus before the cells turn into esophageal cancer. Your treatment may include:

Medical therapy. The mainstay of treatment for Barrett’s esophagus is use of medications called proton pump inhibitors (PPIs), which block the production of stomach acid. PPIs may help decrease the chance that Barrett’s will progress to cancer.

Radiofrequency ablation (RFA). Our endoscopists use an advanced form of ablation (tissue destruction) that delivers heat in a precise and highly controlled manner to destroy the abnormal cells lining the esophagus. With this therapy, we can remove Barrett’s tissue while limiting damage to normal surrounding tissue. In most patients, Barrett’s esophagus tissue returns to normal after RFA treatment.

Cryotherapy involves the use of a super-cooled liquid or gas to freeze the abnormal cells of Barrett's esophagus. The effect of this treatment is similar to RFA.

Endoscopic mucosal resection (EMR). Our endoscopists use this technique to remove Barrett’s esophagus nodules (raised lesions) that contain precancerous changes or early cancer. EMR may spare some people with early esophageal cancer from surgery.

Endoscopic submucosal dissection (ESD) involves the removal of large areas of precancerous changes or early esophageal cancer in an outpatient procedure. Surgery for Barrett’s esophagus. If you have a large or deep lesion in your esophagus, you may need surgery to remove a portion of the esophagus. The upper digestive and thoracic surgeons at NewYork-Presbyterian are highly skilled in performing the full range of surgical techniques for the esophagus and use minimally invasive approaches whenever possible, returning you to your normal activities as soon as possible.

Why Choose Us

At NewYork-Presbyterian, we have an array of advanced techniques to diagnose Barrett’s esophagus and detect precancerous changes or early cancer, including methods not routinely available elsewhere. Weill Cornell Medicine and Columbia University investigators are also involved in numerous clinical trials studying novel treatments for Barrett’s esophagus and esophageal precancer, and we are pleased to offer participation in these studies to our patients who qualify. We are constantly striving to identify new ways to lower the risk of esophageal cancer. Make an appointment with us today to find out how we can help you.