Tests and diagnosisBy Mayo Clinic staff
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|Barrett's esophagus diagnosis|
Diagnosing Barrett's esophagus
Your doctor determines whether you have Barrett's esophagus using a procedure called upper endoscopy to:
- Examine your esophagus. Your doctor will pass a lighted tube (endoscope) down your throat. The tube carries a tiny camera that allows your doctor to examine your esophagus. Your doctor looks for signs that the esophageal tissue is changing. Normal esophagus tissue appears pale and glossy. A person with Barrett's esophagus has tissue that appears red and velvety.
- Remove tissue samples. If the lining of your esophagus appears abnormal, your doctor may pass special tools through the endoscope to remove several small tissue samples. The samples are tested in a laboratory to determine what types of changes are taking place and how advanced the changes are.
Determining the degree of tissue changes
A doctor who specializes in examining tissue in a laboratory (pathologist) will examine your esophageal biopsy samples under a microscope. The pathologist determines the degree of changes (dysplasia) in your cells. Grades of dysplasia include:
- No dysplasia. If no changes are found in the cells, the pathologist determines there is no dysplasia.
- Low-grade dysplasia. Cells with low-grade dysplasia may show small signs of changes.
- High-grade dysplasia. Cells with high-grade dysplasia show many changes. High-grade dysplasia is thought to be the final step before cells change into esophageal cancer.
The type of dysplasia detected in your esophageal tissue determines your treatment options.
- Spechler SJ, et al. Barrett's esophagus. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 25, 2011.
- Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Bethesda, Md.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/BarrettsEsophagus08.pdf. Accessed March 25, 2011.
- Azodo IA, et al. Barrett's esophagus. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/barretts.asp. Accessed March 25, 2011.
- Spechler SJ, et al. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology. 2011;140:1084.
- Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/index.htm. Accessed March 25, 2011.
- Crockett SD, et al. Health-related quality of life in patients with Barrett's esophagus: A systematic review. Clinical Gastroenterology and Hepatology. 2009;7:613.
- Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm. Accessed March 28, 2011.
- Greenwald BD, et al. Cryotherapy for Barrett's esophagus and esophageal cancer. Current Opinion in Gastroenterology. In press. Accessed May 23, 2011.