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Barrett esophagus

MedGen UID:
2551
Concept ID:
C0004763
Disease or Syndrome
Synonyms: BARRETT METAPLASIA; Barrett's esophagus
SNOMED CT: Barrett esophagus (302914006); Barretts esophagus (302914006); Columnar-lined esophagus (302914006); Gastric metaplasia of esophagus (302914006); Barrett's syndrome (302914006); Barrett's esophagus (302914006); CELLO - Columnar epithelial-lined lower esophagus (302914006); CLE - Columnar-lined esophagus (302914006); Columnar epithelial-lined lower esophagus (302914006)
 
Genes (locations): ASCC1 (10q22.1); CTHRC1 (8q22.3); MSR1 (8p22)
 
HPO: HP:0100580
Monarch Initiative: MONDO:0013662
OMIM®: 614266
Orphanet: ORPHA1232

Definition

Barrett esophagus, or Barrett metaplasia, describes the phenotypic change of normal esophageal squamous epithelium to a columnar and intestinal-type epithelium. This metaplastic change is important because patients with Barrett esophagus have an increased risk of esophageal adenocarcinoma. The main cause of Barrett metaplasia is gastroesophageal reflux (GER; 109350). The retrograde movement of acid and bile salts from the stomach into the esophagus in this disease causes prolonged injury to the esophageal epithelium and induces chronic esophagitis, which in turn is believed to trigger the pathologic changes (summary by Wong et al., 2005). [from OMIM]

Clinical features

From HPO
Barrett esophagus
MedGen UID:
2551
Concept ID:
C0004763
Disease or Syndrome
Barrett esophagus, or Barrett metaplasia, describes the phenotypic change of normal esophageal squamous epithelium to a columnar and intestinal-type epithelium. This metaplastic change is important because patients with Barrett esophagus have an increased risk of esophageal adenocarcinoma. The main cause of Barrett metaplasia is gastroesophageal reflux (GER; 109350). The retrograde movement of acid and bile salts from the stomach into the esophagus in this disease causes prolonged injury to the esophageal epithelium and induces chronic esophagitis, which in turn is believed to trigger the pathologic changes (summary by Wong et al., 2005).
Carcinoma of esophagus
MedGen UID:
56256
Concept ID:
C0152018
Neoplastic Process
The presence of a carcinoma of the esophagus.
Esophageal ulceration
MedGen UID:
56254
Concept ID:
C0151970
Disease or Syndrome
Defect in the epithelium of the esophagus, essentially an open sore in the lining of the esophagus.
Gastroesophageal reflux
MedGen UID:
1368658
Concept ID:
C4317146
Finding
A condition in which the stomach contents leak backwards from the stomach into the esophagus through the lower esophageal sphincter.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBarrett esophagus
Follow this link to review classifications for Barrett esophagus in Orphanet.

Conditions with this feature

Barrett esophagus
MedGen UID:
2551
Concept ID:
C0004763
Disease or Syndrome
Barrett esophagus, or Barrett metaplasia, describes the phenotypic change of normal esophageal squamous epithelium to a columnar and intestinal-type epithelium. This metaplastic change is important because patients with Barrett esophagus have an increased risk of esophageal adenocarcinoma. The main cause of Barrett metaplasia is gastroesophageal reflux (GER; 109350). The retrograde movement of acid and bile salts from the stomach into the esophagus in this disease causes prolonged injury to the esophageal epithelium and induces chronic esophagitis, which in turn is believed to trigger the pathologic changes (summary by Wong et al., 2005).
Gastroesophageal reflux disease
MedGen UID:
6553
Concept ID:
C0017168
Disease or Syndrome
Gastroesophageal reflux (GER) is characterized by the retrograde movement of stomach contents into the esophagus. In its most severe form, GER results in extensive tissue damage caused by acid reflux. In adolescents and adults, and even infrequently in children, chronic GER is associated with the risk of developing Barrett metaplasia (614266), a premalignant lesion of the esophageal mucosa (Hu et al., 2000). In turn, Barrett metaplasia is correlated with the development of adenocarcinoma of the esophagus (see 614266), estimated as the fifth most prevalent neoplasia in the Western world (Lagergren et al., 1999).
Mungan syndrome
MedGen UID:
369554
Concept ID:
C1969653
Disease or Syndrome
Mungan syndrome (MGS) is characterized by chronic intestinal pseudoobstruction (CIPO), megaduodenum, long-segment Barrett esophagus, and cardiac abnormalities of variable severity (summary by Bonora et al., 2015).
Visceral myopathy 2
MedGen UID:
1783630
Concept ID:
C5543466
Disease or Syndrome
Visceral myopathy-2 (VSCM2) is characterized by gastrointestinal symptoms resulting from intestinal dysmotility and paresis, including abdominal distention, pain, nausea, and vomiting. Some patients exhibit predominantly esophageal symptoms, with hiatal hernia and severe reflux resulting in esophagitis and stricture, whereas others experience chronic intestinal pseudoobstruction. Bladder involvement resulting in megacystis and megaureter has also been observed and may be evident at birth (Dong et al., 2019; Gilbert et al. (2020)).

Professional guidelines

PubMed

Weusten BLAM, Bisschops R, Dinis-Ribeiro M, di Pietro M, Pech O, Spaander MCW, Baldaque-Silva F, Barret M, Coron E, Fernández-Esparrach G, Fitzgerald RC, Jansen M, Jovani M, Marques-de-Sa I, Rattan A, Tan WK, Verheij EPD, Zellenrath PA, Triantafyllou K, Pouw RE
Endoscopy 2023 Dec;55(12):1124-1146. Epub 2023 Oct 9 doi: 10.1055/a-2176-2440. PMID: 37813356
Farrell B, Pottie K, Thompson W, Boghossian T, Pizzola L, Rashid FJ, Rojas-Fernandez C, Walsh K, Welch V, Moayyedi P
Can Fam Physician 2017 May;63(5):354-364. PMID: 28500192Free PMC Article
Lightdale JR, Gremse DA; Section on Gastroenterology, Hepatology, and Nutrition
Pediatrics 2013 May;131(5):e1684-95. Epub 2013 Apr 29 doi: 10.1542/peds.2013-0421. PMID: 23629618

Curated

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Esophageal and Esophagogastric Junction Cancers, 2024

UK NICE Guidance, NICE Guideline NG231, Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management, 2023

UK NICE Clinical Guideline CG184, Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management, 2019

Recent clinical studies

Etiology

Patil DT, Odze RD
Gastroenterol Clin North Am 2024 Mar;53(1):1-23. Epub 2023 Dec 12 doi: 10.1016/j.gtc.2023.11.002. PMID: 38280743
Sharma P
JAMA 2022 Aug 16;328(7):663-671. doi: 10.1001/jama.2022.13298. PMID: 35972481
Bujanda DE, Hachem C
Mo Med 2018 May-Jun;115(3):211-213. PMID: 30228724Free PMC Article
Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology
Am J Gastroenterol 2016 Jan;111(1):30-50; quiz 51. Epub 2015 Nov 3 doi: 10.1038/ajg.2015.322. PMID: 26526079Free PMC Article
Spechler SJ, Goyal RK
N Engl J Med 1986 Aug 7;315(6):362-71. doi: 10.1056/NEJM198608073150605. PMID: 2874485

Diagnosis

Eluri S, Shaheen NJ
Gastrointest Endosc 2017 May;85(5):889-903. Epub 2017 Jan 18 doi: 10.1016/j.gie.2017.01.007. PMID: 28109913Free PMC Article
Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology
Am J Gastroenterol 2016 Jan;111(1):30-50; quiz 51. Epub 2015 Nov 3 doi: 10.1038/ajg.2015.322. PMID: 26526079Free PMC Article
Falk GW
Gastroenterol Clin North Am 2015 Jun;44(2):xiii. Epub 2015 Apr 9 doi: 10.1016/j.gtc.2015.03.003. PMID: 26021207
Spechler SJ, Souza RF
N Engl J Med 2014 Aug 28;371(9):836-45. doi: 10.1056/NEJMra1314704. PMID: 25162890
Spechler SJ, Goyal RK
N Engl J Med 1986 Aug 7;315(6):362-71. doi: 10.1056/NEJM198608073150605. PMID: 2874485

Therapy

Dunbar KB
Ann Intern Med 2024 Aug;177(8):ITC113-ITC128. Epub 2024 Aug 13 doi: 10.7326/AITC202408200. PMID: 39133924
Sharma P
JAMA 2022 Aug 16;328(7):663-671. doi: 10.1001/jama.2022.13298. PMID: 35972481
Salminen P, Grönroos S, Helmiö M, Hurme S, Juuti A, Juusela R, Peromaa-Haavisto P, Leivonen M, Nuutila P, Ovaska J
JAMA Surg 2022 Aug 1;157(8):656-666. doi: 10.1001/jamasurg.2022.2229. PMID: 35731535Free PMC Article
Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC
Cochrane Database Syst Rev 2021 Mar 4;3(3):CD004060. doi: 10.1002/14651858.CD004060.pub3. PMID: 33661543Free PMC Article
Spechler SJ, Souza RF
N Engl J Med 2014 Aug 28;371(9):836-45. doi: 10.1056/NEJMra1314704. PMID: 25162890

Prognosis

Iyer PG, Kaul V
Mayo Clin Proc 2019 Sep;94(9):1888-1901. doi: 10.1016/j.mayocp.2019.01.032. PMID: 31486383
Sanz Álvarez L, Turienzo Santos E, Rodicio Miravalles JL, Moreno Gijón M, Amoza Pais S, Sanz Navarro S, Rizzo Ramos A
Cir Esp (Engl Ed) 2019 Oct;97(8):465-469. Epub 2019 May 3 doi: 10.1016/j.ciresp.2019.03.012. PMID: 31060735
Barnes JA, Willingham FF
J Clin Gastroenterol 2015 Sep;49(8):638-46. doi: 10.1097/MCG.0000000000000353. PMID: 26125458
Runge TM, Abrams JA, Shaheen NJ
Gastroenterol Clin North Am 2015 Jun;44(2):203-31. Epub 2015 Apr 9 doi: 10.1016/j.gtc.2015.02.001. PMID: 26021191Free PMC Article
Chang P, Friedenberg F
Gastroenterol Clin North Am 2014 Mar;43(1):161-73. Epub 2013 Dec 27 doi: 10.1016/j.gtc.2013.11.009. PMID: 24503366Free PMC Article

Clinical prediction guides

Tan WK, Maroni R, Offman J, Zamani SA; BEST3 Trial Team, Sasieni PD, Fitzgerald RC
Gastroenterology 2024 Sep;167(4):798-800.e4. Epub 2024 May 6 doi: 10.1053/j.gastro.2024.04.030. PMID: 38718951
Sharma P
JAMA 2022 Aug 16;328(7):663-671. doi: 10.1001/jama.2022.13298. PMID: 35972481
Kröner PT, Engels MM, Glicksberg BS, Johnson KW, Mzaik O, van Hooft JE, Wallace MB, El-Serag HB, Krittanawong C
World J Gastroenterol 2021 Oct 28;27(40):6794-6824. doi: 10.3748/wjg.v27.i40.6794. PMID: 34790008Free PMC Article
Katzka DA, Fitzgerald RC
Dig Dis Sci 2020 Jan;65(1):18-21. doi: 10.1007/s10620-019-05965-0. PMID: 31754994
Varghese S, Lao-Sirieix P, Fitzgerald RC
Gastroenterology 2012 Mar;142(3):435-441.e2. Epub 2012 Jan 20 doi: 10.1053/j.gastro.2012.01.013. PMID: 22266150

Recent systematic reviews

Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC
Cochrane Database Syst Rev 2021 Mar 4;3(3):CD004060. doi: 10.1002/14651858.CD004060.pub3. PMID: 33661543Free PMC Article
Klair JS, Zafar Y, Nagra N, Murali AR, Jayaraj M, Singh D, Rustagi T, Krishnamoorthi R
Dig Dis 2021;39(6):561-568. Epub 2021 Jan 27 doi: 10.1159/000514786. PMID: 33503615
Rubenstein JH, Inadomi JM
Gastrointest Endosc Clin N Am 2021 Jan;31(1):77-90. Epub 2020 Oct 26 doi: 10.1016/j.giec.2020.08.005. PMID: 33213801
Yeung KTD, Penney N, Ashrafian L, Darzi A, Ashrafian H
Ann Surg 2020 Feb;271(2):257-265. doi: 10.1097/SLA.0000000000003275. PMID: 30921053
Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK
Obes Surg 2013 Nov;23(11):1890-8. doi: 10.1007/s11695-013-1026-8. PMID: 23934271

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NCCN, 2024
      NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Esophageal and Esophagogastric Junction Cancers, 2024
    • NICE, 2023
      UK NICE Guidance, NICE Guideline NG231, Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management, 2023
    • NICE, 2019
      UK NICE Clinical Guideline CG184, Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management, 2019

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