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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

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
Iyer PG, Kaul V
Mayo Clin Proc 2019 Sep;94(9):1888-1901. doi: 10.1016/j.mayocp.2019.01.032. PMID: 31486383
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

Diagnosis

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
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
Spechler SJ, Souza RF
N Engl J Med 2014 Aug 28;371(9):836-45. doi: 10.1056/NEJMra1314704. PMID: 25162890

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
di Pietro M, Canto MI, Fitzgerald RC
Gastroenterology 2018 Jan;154(2):421-436. Epub 2017 Aug 2 doi: 10.1053/j.gastro.2017.07.041. PMID: 28778650Free 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
Kuipers EJ, Spaander MC
Dig Dis Sci 2018 Aug;63(8):1997-2004. doi: 10.1007/s10620-018-5161-x. PMID: 29905908Free PMC Article
Splittgerber M, Velanovich V
Surg Clin North Am 2015 Jun;95(3):593-604. doi: 10.1016/j.suc.2015.02.011. PMID: 25965132
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
Falk GW
Gastroenterology 2002 May;122(6):1569-91. doi: 10.1053/gast.2002.33427. PMID: 12016424

Clinical prediction guides

Zou Q, Feng L, Cai X, Qian Y, Xu L
Front Cell Infect Microbiol 2023;13:1145791. Epub 2023 May 19 doi: 10.3389/fcimb.2023.1145791. PMID: 37274313Free PMC Article
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
Gaddam S
Dis Esophagus 2018 Mar 1;31(3) doi: 10.1093/dote/dox147. PMID: 29346553
Gupta M, Iyer PG
Gastroenterol Clin North Am 2015 Jun;44(2):265-83. doi: 10.1016/j.gtc.2015.02.003. PMID: 26021194

Recent systematic reviews

Valentini DF Jr, Mazzini GS, Lazzarotto-da-Silva G, Simões AB, Gazzi VS, Alves JBO, Campos VJ, Gurski RR
J Gastrointest Surg 2024 Sep;28(9):1546-1557. Epub 2024 Jun 18 doi: 10.1016/j.gassur.2024.06.014. PMID: 38901554
Kim SE, Schlottmann F, Masrur MA
J Laparoendosc Adv Surg Tech A 2023 Dec;33(12):1201-1210. Epub 2023 Oct 4 doi: 10.1089/lap.2023.0321. PMID: 37796531
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
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
Shiota S, Singh S, Anshasi A, El-Serag HB
Clin Gastroenterol Hepatol 2015 Nov;13(11):1907-18. Epub 2015 Aug 7 doi: 10.1016/j.cgh.2015.07.050. PMID: 26260107Free PMC Article

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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