Barretts Esophagus

Barrett's esophagus screening and diagnosis

If you have heartburn on a regular basis and certain risk factors, an expert should screen you for Barrett’s esophagus. The condition may be a precursor to esophageal cancer. But early detection and treatment may help you stay healthy.

City of Hope has a team that specializes in detecting Barrett’s esophagus. We offer screening tests to identify problems as early as possible and the expertise to help you understand next steps.

Cancer Treatment Centers of America® (CTCA) is now City of Hope®, joining forces to expand patient access to personalized, comprehensive cancer care.

Screening for Barrett's disease

Frequent heartburn, acid reflux and/or gastroesophageal reflux disease (GERD) may cause permanent damage to the esophageal lining. The cells that line the esophagus may change over time, and they sometimes become cancerous.

If you often experience these symptoms, you may benefit from the comprehensive screening options we offer in our If you often experience these symptoms, you may benefit from the comprehensive screening options we offer in our Barrett’s esophagus treatment program. At City of Hope, our experts recommend screening for Barrett’s esophagus for people who have both:

  • Weekly, chronic symptoms of GERD (at least once a week for five years or more)
  • Two or more additional risk factors for Barrett’s esophagus

The risk factors for Barrett’s esophagus are:

  • Age over 50
  • History of smoking or current smoking habits
  • Obesity or excess weight, especially around the abdomen (belly)
  • White (Caucasian) ethnic background

Barrett's esophagus diagnosis

To diagnose Barrett’s esophagus, a City of Hope gastroenterologist will meet with you to discuss:

  • Your personal medical history and lifestyle
  • Your family’s medical history
  • Any symptoms you have, such as heartburn or difficulty swallowing

If you’re at risk for Barrett’s esophagus, you may need further testing, which may include:

  • Upper endoscopy to look inside the esophagus
  • Biopsy, which takes a small sample of esophageal tissue so an expert can examine the cells under a microscope

Upper endoscopy and biopsy: What to expect

The test to screen for and diagnose Barrett’s esophagus involves upper endoscopy and biopsy. Our team will:

  1. Fully sedate you so that you are comfortable and don’t remember the procedure
  2. Feed an endoscope (tool with a tiny light and camera) down your throat and into your esophagus and stomach
  3. Use the camera to examine the lining of the esophagus, looking for tissue that appears abnormal
  4. Take a small sample of tissue, which is painless, for testing to look for precancerous cells
  5. Have a pathologist evaluate the tissue sample under a microscope

Our team may diagnose Barrett’s esophagus based on our view inside the esophagus and the pathologist’s report on the cells. We’ll immediately explain what we saw during the endoscopy. Biopsy results may take a few days.

Changes in the lining of the esophagus

Normal esophageal tissue is smooth and pale. But with Barrett’s esophagus, the lining appears irregular and reddish, resembling cells in the lining of the intestines.

Our gastroenterologists and pathologists have training and experience in identifying these abnormal cell changes, called dysplasia. A gastroenterologist is a doctor who specializes in disorders of the digestive system. A pathologist is a doctor who is an expert at examining tissue.

Dysplastic cells are not necessarily malignant (cancerous), but they may become cancerous. Our Barrett’s esophagus team will determine whether your cells have:

  • No dysplasia, indicating healthy, unchanged cells
  • Low-grade dysplasia
  • Intermediate dysplasia
  • High-grade dysplasia, which may soon change into cancer

Our team will consider the level of dysplasia when diagnosing Barrett’s esophagus and recommending what happens next.

Short-segment Barrett's esophagus versus long-segment Barrett's esophagus

If your City of Hope care team diagnoses Barrett’s esophagus, we’ll also measure how much of the lining is affected.

The esophagus is about 25 to 33 cm (10 to 13 inches) long. Short-segment Barrett’s esophagus affects less than 3 cm (about 1.2 inches) of the lining. Long-segment Barrett’s affects more than 3 cm.

The longer the segment, the more likely that Barrett's may become esophageal cancer. Our team will consider the length of Barrett’s segment in developing a plan to monitor and treat the condition.

Monitoring and treating Barrett's esophagus

Make an appointment with our Barrett's esophagus team

If you have GERD or other gastrointestinal symptoms, we're ready to help you. To learn more about our Barrett's esophagus care or to make an appointment, call or chat online with a member of our team.