What Everyone Should Know...

Barrett's esophagus is a precancerous condition of the esophagus that typically affects white males over 50 years of age, although others may also have this condition. The incidence of the type of cancer associated with Barrett's esophagus has recently dramatically increased in the United States even though Barrett's-associated cancer may be prevented or cured with early diagnosis and treatment. Diagnosis and treatment services for Barrett's esophagus and esophageal cancers are available at Johns Hopkins.

Barretts pathology slide


Barrett's esophagus is a condition in which the lining of the esophagus changes from its normal lining to a type that is usually found in the intestines.

It is believed that this change is the result of chronic regurgitation (reflux) of the stomach contents up into the esophagus. The contents of the stomach contain digestive acid and other chemicals which damage the normal lining of the esophagus.

In the healing process, the wrong type of cells grow to repair the damaged areas. This phenomenon is referred to as "metaplasia" and, in the case of the esophagus, intestinal metaplasia replaces the normal squamous type cells which line the esophagus. This happens in about 10-15% of people who have long-term reflux. [1]

Once the metaplastic cells have replaced the normal ones, the patient frequently feels less discomfort since the metaplastic areas seem to be less sensitive than the normal tissue. Unfortunately, patients with intestinal metaplasia are at increased risk of developing cancer of the esophagus over those without it, so being symptom-free does not equate with being disease-free.

Importantly, with proper testing, doctors can detect these cancers early, before they have spread. There are precancerous stages that the metaplastic tissue goes through before the development of cancer, and these precancerous stages are classified as dysplasia. Dysplasia is detected by performing endoscopic biopsies from the esophagus.


1. Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol. 2016 Jan;111(1):30-50.