Barrett’s oesophagus has no symptoms. But most people with Barrett’s oesophagus have symptoms of gastro-oesophageal reflux disease (GERD). The most common symptoms of GERD are heartburn and indigestion.
Other symptoms include:
- an unpleasant taste in the mouth
- feeling sick
- being sick
- difficulty swallowing food
- pain when swallowing food
- chest pain
In some people, the valve that joins the oesophagus to the stomach is weak. This means stomach juices and acid come up into the oesophagus.
Your risk of developing reflux is bigger if you:
- are overweight
- smoke
- drink too much alcohol
- eat spicy, acidic, or fatty foods
- have a hiatus hernia.
A hiatus hernia is when part of the stomach moves up through the diaphragm, into the chest space. The diaphragm is the sheet of muscle that divides the tummy area (abdomen) from the chest. It helps keep acid and bile in the stomach.
Acid made by the stomach can come through the stomach valve and into the oesophagus. In some people, the acid can irritate the oesophagus, causing pain and heartburn. The changes to cells in Barrett’s oesophagus are caused by contact with acid during reflux over a long time.
Not everyone with acid reflux develops Barrett's oesophagus. About 5 in 100 people with acid reflux (5%) develop Barrett's oesophagus. It is more likely to develop in people who have had severe reflux for many years.
Barrett’s oesophagus is managed differently for each person.
The aim of medical treatment for Barrett’s oesophagus is to reduce acid reflux and control symptoms. You may have an operation to strengthen the valve at the bottom of the oesophagus. Or you may have surgery to remove the affected area.
Recommended lifestyle changes:
- Eat small meals during the day
- Do not eat for 2 to 3 hours before bedtime
- Raise the head end of your bed by 10 to 20cm if you have reflux at night. This will position your stomach below your chest and head, so acid cannot travel upwards. You can do this by putting something under your bed or mattress
- Avoid spicy or fatty foods and alcohol. These may make symptoms worse
- Keep to a healthy weight.
- Stop smoking
Nutritional therapeutic aims:
- Decrease oesophageal inflammation
- Mucosal support
- Digestive/ Pancreatic support
- Addressing motility issues
- Looking at bile secretion and protein digestion
- Rebalancing microbiome
- Supporting enteric nervous system
- Addressing any possible food allergies or intolerances