Barrett's Esophagus

Duke esophageal specialists use a comprehensive approach to diagnose and treat Barrett’s esophagus. If you suspect or have been diagnosed with Barrett’s esophagus, it’s important to seek care from a team of esophageal specialists as the condition can lead to esophageal cancer. Regular check-ups can identify changes before cancer occurs, and ensure effective treatment begins promptly.

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Understanding Barrett’s Esophagus

Barrett's esophagus is a common condition often associated with gastroesophageal reflux disease (GERD), also known as acid reflux. Some people with Barrett’s esophagus no longer have symptoms of GERD or never had any symptoms.

Barrett’s esophagus often occurs when GERD damages and changes the cells in the lining of the esophagus, the tube-like organ that connects the mouth to the stomach. Early changes, called dysplasia, can lead to esophageal cancer. That's why it's important to work with an esophageal specialist. If you are diagnosed with Barrett’s esophagus they will monitor your condition regularly to detect these changes early. Treatment at this stage is highly effective.

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Diagnosing Barrett’s Esophagus

Upper Endoscopy

An upper endoscopy is the most common way to diagnose Barrett’s esophagus. Your gastroenterologist will insert a flexible lighted tube called an endoscope into your mouth to look for changes inside your esophagus.

Endoscopic Biopsies

During the endoscopy, your gastroenterologist may remove small tissue samples to view under a microscope. This testing is used to study the cells and identify the presence of dysplasia, which may include precancerous or cancerous cells.

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If No Abnormal Cells Are Found

If no suspicious cells are seen under a microscope, your doctor will schedule regular checkups and follow-ups to watch for the development of abnormal cells. Biopsies may be performed periodically as well. Follow-up endoscopy may be scheduled every 3 to 5 years or sooner, depending on your condition.

Proton Pump Inhibitors (PPI)

These medications can reduce the symptoms associated with GERD and reduce the risk associated with Barrett’s esophagus. They are often prescribed for long-term use and to help with the healing process if endoscopic treatments are recommended.

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2025–2026.

If Precancerous or Cancerous Cells (Dysplasia) Are Found

One or more of these treatments may be recommended to remove precancerous or cancerous cells. An endoscopy expert performs these procedures.

Radiofrequency Ablation

Radiofrequency ablation uses heat to destroy abnormal cells in the lining of your esophagus. Your doctor will use an endoscope to insert a thin tube called a catheter down your throat and into your esophagus. Electrodes on this catheter destroy cancerous cells and allow the esophagus to heal.

Cryoablation

Cryoablation is similar to radiofrequency ablation. Instead of heat, this treatment freezes the abnormal cells to destroy them.

Hybrid-Argon Plasma Coagulation (Hybrid APC)

This procedure, which may also be called argon photocoagulation, is performed during an upper endoscopy. It uses argon gas and an electrical current to remove and destroy abnormal or cancerous tissue.

Endoscopic Mucosal Resection (EMR)

This procedure is performed through an endoscope. Your doctor will use small instruments to remove severely abnormal cells that have not yet grown into the esophagus lining. This is typically considered early-stage cancer.

Endoscopic Submucosal Dissection (ESD)

Endoscopic submucosal dissection is similar to endoscopic mucosal resection, however, it removes larger, more serious areas of suspicious tissue and abnormal cells found under or beneath the esophageal lining.

Related Treatments

Esophageal Cancer

Gastroesophageal Reflux Disease (GERD) and Hiatal Hernia

Why Choose Duke

A Dedicated Esophageal Center
Seeking care at a dedicated esophageal center means you will benefit from a team of providers including gastroenterologists and thoracic surgeons specializing in esophageal diseases such as Barrett’s esophagus. Managing your care may require regularly scheduled visits for evaluation, testing, and procedures, when needed, as well as follow-up care. Our esophageal specialists work together so you receive the comprehensive care you need.

Extensive Experience in Barrett’s Esophagus
Doctors refer their patients to us because of our extensive experience diagnosing and treating Barrett’s esophagus. Our gastroenterologists have completed specialized training and are highly skilled in endoscopy to diagnose and monitor Barrett’s esophagus, GERD, and other esophageal disorders. Our board-certified surgeons have additional fellowship training in thoracic surgery. This includes specialized procedures in and around the esophagus.

Access to Clinical Trials
You may be eligible to participate in our ongoing clinical trials, which test new therapies and approaches to treating Barrett’s esophagus and related conditions, including GERD.

Dedicated Care Coordinators
Our care coordinators and social workers help you navigate every aspect of your care, including appointment scheduling, insurance coverage, and access to support resources.

This page was medically reviewed on 03/13/2024 by

David A. Leiman, MD, MSHP | Gastroenterologist