Carlos, 48 years old, has always believed that heartburn was part of his routine. After meals, especially at night, he felt intense burning in his chest, a bitter taste in his mouth, and a sensation of food coming back up his throat. Over time, he began to notice difficulty swallowing certain foods and frequent episodes of dry cough during the night.

Like many people, he tried to relieve the symptoms only with specific dietary changes and over-the-counter medications. However, after years of dealing with frequent reflux, he decided to seek medical evaluation. During the investigation, he underwent upper endoscopy and received a diagnosis of Barrett's Esophagus.

This is a condition that deserves attention because it is related to changes in the cells of the esophagus caused by continuous exposure to stomach acid.

What is Barrett's Esophagus?

Barrett's Esophagus is an alteration in the inner lining of the esophagus, usually caused by chronic gastroesophageal reflux. In this condition, the normal cells of the esophagus undergo transformation due to constant irritation caused by gastric acid.

Although not everyone with reflux develops Barrett's Esophagus, the risk increases when symptoms persist for many years without proper treatment.

The main concern related to Barrett's is that, in some cases, it can increase the risk of developing esophageal cancer, especially esophageal adenocarcinoma.

Main symptoms

Many people do not present specific symptoms of Barrett's Esophagus itself, but usually have signs related to gastroesophageal reflux, such as:

  • Frequent heartburn

  • Burning sensation in the chest

  • Sensation of food reflux

  • Bitter taste in the mouth

  • Pain or discomfort after meals

  • Persistent dry cough

  • Frequent hoarseness

  • Difficulty swallowing

  • Sensation of food stuck in the throat

In some cases, symptoms may decrease over time, even with disease progression, which leads many people to believe there has been spontaneous improvement.

Main causes

The main cause of Barrett's Esophagus is chronic gastroesophageal reflux. The repeated contact of stomach acid with the esophagus causes continuous aggression to the esophageal mucosa.

Other factors can also contribute to the development of the condition:

  • Hiatal hernia

  • Obesity, especially abdominal

  • Smoking

  • Excessive alcohol consumption

  • Diet rich in fatty and ultra-processed foods

  • Prolonged history of reflux

  • Male sex

  • Age over 50 years

  • Family history of Barrett's or esophageal cancer

Risk factors that deserve attention

Some situations significantly increase the risk of developing Barrett's Esophagus:

  • Reflux for more than 5 years

  • Symptoms of frequent heartburn, especially at night

  • Excess weight

  • Sedentary lifestyle

  • Chronic smoking

  • Inadequate diet

  • Presence of hiatal hernia

People with persistent reflux should seek medical evaluation, especially when symptoms become frequent or begin to interfere with quality of life.

How is the diagnosis made?

The main examination used for diagnosis is upper endoscopy.

During the examination, the doctor observes changes in the esophageal mucosa and, when necessary, performs biopsies for microscopic analysis of the cells.

The biopsy is essential because it helps identify whether there are cellular changes called dysplasia, which may indicate a higher risk of progression to cancer.

In some cases, periodic follow-up with new endoscopies may be necessary to monitor disease progression.

What is the treatment?

The treatment of Barrett's Esophagus depends on the degree of alteration found on examinations.

The main objectives are to control reflux, reduce inflammation, and monitor possible cellular changes.

The approaches may include:

Lifestyle changes

  • Weight loss

  • Avoid large meals before bedtime

  • Reduce fatty and highly acidic foods

  • Stop smoking

  • Decrease alcohol consumption

  • Elevate the head of the bed

  • Improve eating habits

Medication treatment

The most commonly used medications are proton pump inhibitors, which help reduce stomach acid production and control reflux.

Endoscopic treatments

When there are significant cellular changes, specific procedures performed by endoscopy may be indicated for removal or destruction of the altered areas.

Surgery

In some patients, especially in cases associated with significant hiatal hernia or severe reflux that is difficult to control, anti-reflux surgery may be considered.

The importance of follow-up

Barrett's Esophagus does not necessarily mean cancer. However, it is a condition that requires proper follow-up, especially when cellular changes are identified on biopsy.

Early diagnosis and proper treatment help reduce complications and significantly improve the patient's quality of life.

Ignoring persistent reflux symptoms can delay important diagnoses.

Final message

Experiencing heartburn occasionally can happen, but frequent reflux should not be considered normal. Persistent symptoms deserve proper medical investigation.

This content is for informational and educational purposes only. It does not replace medical consultation, professional evaluation, or performance of examinations. If you have symptoms or questions, seek follow-up care with a physician.

Dr. Rebeca Soares Andrade CRM-GO 39335