What Is Barrett’s Esophagus and Why Does it Matter?
Barrett’s esophagus is a precancerous condition of the esophagus (the food tube which connects the mouth and stomach). Barrett’s is almost always seen with long-standing reflux or heartburn. Years of stomach acid in the esophagus irritate the lining and eventually transform the lining. Barrett’s can generally be seen if you have a scope down the mouth. It shows up as a slightly darker area of the lower esophagus.
If you have Barrett’s, you almost certainly have chronic reflux…even if you don’t have symptoms. Barrett’s is a precursor to cancer…therefore, we want to stop the reflux to stop the progression to cancer. In addition, Barrett’s can be “burned” with certain treatments like the HALO.
Barrett’s is important for bariatric patients for a couple of reasons.
- First, if you have Barrett’s prior to bariatric surgery, it means you have severe reflux. In general, sleeve is not the best choice as it CAN aggravate reflux. The most effective bariatric operation to fix reflux is the gastric bypass. However, this is not a 100% curative. If you overeat after surgery and pile food into your esophagus, even gastric bypass will fail and you will reflux.
- Second, if you develop reflux after bariatric surgery and Barrett’s is found, you need an aggressive approach to deal with both the reflux and the Barrett’s. If you had a sleeve, it may be necessary to do a hiatal hernia repair or even convert you to gastric bypass. If you had gastric bypass, you may need hiatal hernia repair and/or the HALO treatment.
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