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Tests and diagnosis
By Mayo Clinic staff
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. A person with Barrett's esophagus has tissue that appears different from normal esophageal tissue.
- Remove tissue samples. 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 body tissue in a laboratory (pathologist) will examine your esophageal tissue 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.
- Rich HG. Barrett's esophagus. In: Ferri FF. Ferri's Clinical Advisor 2009: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/145544773-3/0/1701/0.html. Accessed June 23, 2009.
- Wang KK, et al. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. American Journal of Gastroenterology. 2008;103:788.
- Azodo IA, et al. Barrett's esophagus. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/barretts.asp. Accessed June 23, 2009.
- Shaheen NJ, et al. Barrett's oesophagus. The Lancet. 2009;373:850.
- Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddieases/pubs/barretts/index.htm. Accessed June 23, 2009.
- 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.
- Waxman I, et al. Mucosal ablation of Barrett esophagus. Nature Reviews Gastroenterology & Hepatology. In press. http://www.nature.com/nrgastro/journal/vaop/ncurrent/abs/nrgastro.2009.90.html. Accessed June 24, 2009.
- Sharma P, et al. Management of nondysplastic Barrett's esophagus: Where are we now? American Journal of Gastroenterology. 2009;104:805.
- HALO 360 System. Barrx Medical, Inc. http://www.barrx.com/Patients_and_Families/index.cfm/421. Accessed June 25, 2009.
- 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 June 29, 2009.
