How do I know for sure if I have Barrett's esophagus?

There are no heartburn symptoms specific for or diagnostic of Barrett's esophagus. A procedure called esophagogastroduodenoscopy (EGD or upper endoscopy) with biopsy is the ONLY way to know for sure whether you have Barrett's esophagus. If you have specialized intestinal metaplasia of the esophagus based on histologic analysis of an ESOPHAGEAL biopsy, you are at increased risk for the development of a type of esophageal cancer called esophageal adenocarcinoma. It is recommended that you undergo periodic endoscopic biopsy surveillance (cancer surveillance) to be able to detect a cancer when it is early and curable.

Unfortunately, most patients who have Barrett's esophagus never see a doctor for their heartburn symptoms. The vast majority of patients who develop an advanced (large) esophageal cancer are unaware that they have Barrett's esophagus.

Barrett's esophagus is commonly diagnosed because of another complication of heartburn (GERD), such as bleeding or dysphagia due to a stricture (food getting stuck in the esophagus due to esophageal narrowing). Sometimes doctors refer patients for upper endoscopy to check for Barrett's esophagus because the patient still has heartburn symptoms on medication. However, even if your heartburn symptoms go away on medication or without any treatment, you can have still Barrett's esophagus or esophageal adenocarcinoma.

As patients and physicians become more aware of Barrett's esophagus as a complication of GERD, more patients may seek medical attention for their heartburn and be referred by their physician for upper endoscopy to look for Barrett's esophagus. It has been recommended that patients who have a history of GERD for at least five years and are age 50 or older should undergo upper endoscopy to look for Barrett's esophagus. Barrett's esophagus should always be suspected in a Caucasian (white) man who has a longstanding problem with heartburn. However, ANYONE of any age, gender or race who has a chronic problem with heartburn could have Barrett's esophagus.