Barrett’s esophagus is a condition in which acid reflux damages the lining of the esophagus, or food pipe. Medications and other treatments can help prevent further damage.
Medications for Barrett’s esophagus aim to prevent and heal damage to the esophagus by reducing stomach acid or increasing movement in the gastrointestinal (GI) tract.
Dietary changes, such as avoiding certain foods and drinks, may also help reduce reflux symptoms. People will also likely benefit from reaching or maintaining a moderate weight and quitting smoking, if applicable.
In some cases, surgery and other medical procedures may be among the treatment options.
This article looks at the types of medications available to treat Barrett’s esophagus. It also discusses other treatment options and provides lifestyle tips.
The esophagus is a tube connecting the mouth and stomach that transports food and liquids.
Barrett’s esophagus is a chronic condition that occurs when the lining of the esophagus changes into tissue similar to the lining of the intestine.
The lining of the esophagus changes from its usual white color to a salmon pink color.
Although there is no clear cause of Barrett’s esophagus, people with gastroesophageal reflux disease (GERD) have an
Other risk factors include obesity and smoking. Genetics may also play a part.
Barrett’s esophagus does not cause symptoms, but people may have symptoms of GERD. These symptoms, which can be persistent, typically include:
- heartburn
- indigestion
- blood in the stool or vomit
- problems swallowing solid food
- bitter or acidic liquid coming up into the chest or mouth during sleep
People with Barrett’s esophagus can discuss a treatment plan with a doctor to find the best approach. The treatment options may include medications, medical procedures, and, in some cases, surgery.
Medications for treating Barrett’s esophagus work by either reducing acid levels in the stomach or increasing movement in the upper GI tract.
Proton pump inhibitors
Proton pump inhibitors (PPIs) are acid-suppressing medications. PPIs work to
PPIs prevent the three main pathways for acid production in the body.
PPIs that a doctor may prescribe include:
- esomeprazole (Nexium)
- dexlansoprazole (Dexilant)
- lansoprazole (Prevacid)
- omeprazole (Prilosec or Zegerid)
- pantoprazole (Protonix)
- rabeprazole (AcipHex)
PPIs are the most effective treatment for healing damage to the esophagus and helping manage GERD symptoms in the long term.
Antacids
Over-the-counter antacid medications may help relieve infrequent reflux symptoms.
However, the frequent use of antacids may increase acid production and worsen the condition.
Histamine 2 blockers
Histamine 2 (H2) blockers reduce the amount of acid the stomach releases, which can help prevent further damage to the esophagus.
In about 50% of people, H2 blockers are effective in healing damage to the lining of the esophagus.
Prokinetic agents
Prokinetic agents are medications that promote movement of the smooth muscle of the GI tract.
Although prokinetic agents are generally not as effective as PPIs, a doctor may prescribe them in combination with acid-suppressing medication.
If lifestyle changes and medications are not effective in managing Barrett’s esophagus and GERD symptoms, people may require other treatments.
People with Barrett’s esophagus have an
Learn more about esophageal cancer.
Periodic surveillance endoscopy
A doctor can perform a regular endoscopy to check for dysplasia. This procedure involves using an endoscope, which is a tube with a light at the end of it, to examine the upper GI tract.
The doctor may also carry out a biopsy, taking a sample of tissue and sending it to a lab where pathologists will examine it for abnormal cell changes.
Depending on the presence and severity of dysplasia, people may need surveillance every 1–2 years or every 3–6 months.
Endoscopic mucosal resection
In an endoscopic mucosal resection, a doctor injects a solution underneath the esophagal tissue before removing it.
People will receive a local anesthetic and sedative before this procedure. A doctor may combine it with other treatments, such as photodynamic therapy.
Photodynamic therapy
A doctor delivers photodynamic therapy by injecting a chemical called porfimer sodium (Photofrin) into a vein. Photofrin is a light-activated medication, which means that it
A doctor will use laser light and an endoscope to focus on any precancerous cells. Photofrin will destroy cancerous cells without harming healthy cells.
Radiofrequency ablation
Radiofrequency ablation uses heat to destroy any precancerous cells in the esophagus. A doctor will use an electrode — a fine wire that an electric current can travel through — and an endoscope to carry out this procedure.
Surgery
Esophagectomy is a surgical procedure to remove any problematic areas of the esophagus. If other treatments are not successful, esophagectomy may be an option.
Following the surgical removal of parts of the esophagus, a surgeon will use sections of the stomach or large intestine to rebuild the esophagus with healthy tissue.
People usually need to stay in the hospital for
An alternative option is a Nissen fundoplication. During this procedure, a surgeon will use part of the stomach to act as an anti-reflux barrier, blocking acid from entering the lower esophagus.
People can take certain steps at home to help relieve acid reflux symptoms. These include:
- avoiding foods that can increase stomach acid, such as caffeine
- refraining from consuming fatty foods, alcohol, and peppermint, as these can reduce pressure in the lower esophagus
- avoiding foods, such as fatty foods, that slow down the process of the stomach emptying food into the small intestine
- limiting the intake of chocolate and tomatoes or tomato products, which may
worsen GERD symptoms - drinking water rather than coffee, alcohol, or any acidic liquids, as these can affect muscle movement in the GI tract
- eating smaller, more frequent meals
- quitting smoking, if applicable, or avoiding secondhand smoke
- staying upright after eating
- elevating the head when lying down
- reaching or maintaining a moderate weight
Learn about foods to eat and avoid for GERD and acid reflux.
Lifestyle changes and medications may help people manage the symptoms of GERD and avoid further damage to the esophagus. Some medications may also help heal existing damage.
PPIs are the most effective medication for healing any erosion of the esophagus and for the long-term management of GERD symptoms.
Surgery may be a suitable option for some people, who might find it preferable to long-term medications. Certain surgical procedures, such as a Nissen fundoplication, may give people permanent relief from reflux symptoms.
Medications, procedures, and surgery can have side effects or possible complications, so a person should discuss these with a doctor.
There is a
Regular surveillance checks can help doctors identify precancerous changes and start treatment before cancer develops.
Barrett’s esophagus is a chronic condition that occurs due to damage to the esophagus. It can be a complication of GERD.
Lifestyle changes can help reduce reflux symptoms. Medications can help prevent further damage to the esophagus, and they may sometimes help heal damaged tissue.
If these treatments are not effective, people may require medical procedures or, in some cases, surgery to remove part of the esophagus.
Doctors may also carry out surveillance checks of the esophagus to check for any precancerous changes.