Barrett's esophagus is a condition where the lining of the esophagus is replaced by abnormal intestinal-type cells due to chronic acid reflux from the stomach. This occurs when stomach acid damages the normal esophageal lining over many years. The abnormal cells are pre-cancerous and increase the risk of developing esophageal adenocarcinoma. The main symptoms of Barrett's esophagus are heartburn and acid reflux. It is diagnosed through an endoscopy with biopsy to examine the abnormal cells under a microscope. The primary cause is gastroesophageal reflux disease which causes excessive stomach acid to back up into the esophagus.

1. Barrett's Esophagus Secrets from a Guy Who Cured Himself
The human body contains many parts and each part works in a different way. If even one part is
slightly defected due to some disease, the human body slowly starts to shut down. It as simple
as when one part is affected, the other parts start to get affected too. Before we move on to
the actual disease, let us study a little about the “Esophagus”.
Esophagus
One of the most delicate parts of the human body is the “Esophagus”. It is a muscular tube,
which connects the pharynx (throat) with the stomach. It is about eight inches long, and is
covered in a moist pink tissue lining called mucosa. The esophagus tube runs behind the
trachea (windpipe), the heart, and in front of the spine. Before it enters the stomach, it passes
through the diaphragm.
The (UES) Upper Esophageal Sphincter is a pack of muscles at the topmost of the esophagus.
These muscles are under conscious control, and they help in belching, breathing, vomiting and
eating. They also prevent secretions and food from going down the windpipe.

2. The (LES) Lower Esophageal Sphincter is a pack of muscles, which are situated at the lower end
of the esophagus, meeting the stomach. When these muscles are closed, they keep the
stomach contents and acid from traveling back from the stomach. These muscles have
inadvertent movements.
Barrett’s Esophagus
What is Barrett’s Esophagus? It is a part of chronic (GERD) Gastroesophageal Reflux Disease. It
is a disease caused due to the reflux of acidic fluid, which travels from the stomach to the
esophagus. The most likely cause of GERD is heartburn.
Symptoms of Barrett’s Esophagus
There are no specific symptoms that define Barrett's Esophagus. Patients having this disease
have symptoms similar to those of GERD, which include:
• Heartburn
• Regurgitation
• Regular Belching
• Nausea
Nonetheless, not all patients having Barrett's have GERD symptoms.

3. The burning sensation felt behind a person’s breastbone is known as Heartburn, which usually
occurs in the lower part of the throat, but sometimes moves up towards the throat. This
burning sensation is accompanied by a particular pain or burning in the stomach or just
beneath the end of the breastbone.
The second common symptom of Barrett’s is regurgitation of acrimonious tasting fluid, which
comes back in to the mouth. GERD symptoms gradually get worse when a person is lying flat or
when a person has finished his or her meal.
The regurgitated, refluxed fluid infrequently enters the Larynx (voice box) or the lungs, which
results in extraesophageal manifestations of GERD, which are found at the outer side of the
esophagus. Some of these symptoms are:
• Sore throats
• Hoarseness
• Frequent Bronchitis
• New onset of adult Asthma
• Chronic cough
GERD might result in ulceration or strictures in the esophagus. The narrowing or stricture is
because of the fibrosis (scarring) the esophagus, which may cause “Dysphagia” (difficulty while
swallowing). Dysphagia is detected as a stopping or sticking of liquids or hard food, when it
passes from the esophagus into the chest, after the narrowing has become severe.
These strictures can be removed or treated by widening them during Endoscopy with dilators.
Untreated strictures might promote spillage of gastric fluids or food in to the lungs. It is rare,
but sometimes-huge Gastrointestinal (GI) bleeding is caused due to inflammation in the
esophagus. The consequences of this bleeding are maroon and black stools, or vomiting of
blood. However, inflamed esophagus may be the origin of slow bleeding, which is detected in
Anemic patients who have low red blood cell count. In this case, for detection of this disease,
stool tests are conducted.

4. Diagnosis of Barrett’s Esophagus
Endoscopy: A long flexible tube, with a camera and a light attached at its tip is inserted in the
mouth, which gives a view of the esophagus.
Biopsy: A sample of the esophagus tissue is taken from its lining.
Both diagnoses must have the following conditions, in order to confirm that a patient has
Barrett’s Esophagus.
Endoscopy
While performing endoscopy, an anomalous pink lining should be visible instead of the
standard white esophagus lining. This anomalous lining prolongs a short distance, less than 2.5
inches towards the esophagus from the Gastroesophageal junction. The place where the
esophagus joins the stomach is known as the GE junction.

5. Biopsy
From the biopsy, the microscopic evaluation must show an anomalous lining that covers the
usual lining cells of the esophagus. This anomalous lining will look like intestinal type lining cells,
which will also include “Goblet Cells” known as mucus-producing cells. Some other cells will
resemble the cells of the lining of the stomach. However, if no goblet cells are found, the
presence of Barrett's esophagus will be a negative.
The Cause of Barrett’s Esophagus
GERD - Gastroesophageal Reflux Disease
The main cause of Barrett’s Esophagus is GERD, also known as Gastroesophageal Reflux
Disease. In this disease, the esophagus which has lower esophageal sphincter, the tube that
passes food from the mouth to the stomach, is affected. The function of LES is to prevent
stomach contents from reverting to the esophagus from the stomach. Due to GERD, the
excessive acidic reflux makes the lower esophageal sphincter weak. This weakness may also be
caused due to the presence of Hiatal Hernia, which patients suffering from GERD also have.

6. Hiatal Hernia
Hiatal Hernia is a disease, in which the top few centimeters of the stomach keeps moving back
and forth, from the abdomen to the chest through the diaphragm. This sliding interferes with
the working of the sphincter, which acts as a barrier to the reflux condition that keeps the acid
from coming up, from the stomach to the esophagus.
Therefore, Barrett's Esophagus is caused due to this chronic motion and severe acid reflux. In
some cases of GERD, the repeated injury due to the reflux of the acidic fluid changes the type of
cell lining in the esophagus from “Squamous” (normal cells) to “Columnar” (intestinal type
cells). This transformation is called “Metaplasia”. Metaplasia is believed to be a defensive
response due to the specialized Columnar epithelium, which is more resilient to the injury from
acid reflux than the Squamous epithelium.
The fluid containing acid that is produced in the stomach, may also contain bile acids produced
by the liver, and enzymes that are produced by the pancreas. These acids may also have
refluxed back from the duodenum in to the stomach. Duodenum is the chief part of the small
intestine, which is just beyond the stomach. The acid, which refluxes back from the stomach to
the esophagus, is harmful to the esophagus. However, some evidence leads to the conclusion
that the pancreatic and bile enzymes when combining with the acid, are more harmful than
acid alone.

7. The crucial area where Barrett's is developed begins at the intersection of the esophageal
linings and the stomach. The esophagus generally is lined by squamous epithelium. The
Squamous epithelium has a pearly whitish appearance, while the lining in the intestine and the
stomach known as Columnar epithelium has a more salmon-pink color. The squamous
epithelium is made of Squamous cells that are identical to skin cells. The gastric or stomach
lining consists of tall columnar cells, when seen under the microscope.
The connection of the Squamous epithelium and the columnar epithelium occurs at the
intersection of the stomach and the esophagus where the lower esophageal sphincter is
situated. The common interface of both linings is frequently referred as the Z-Line, because it
has a zigzag appearance when it is examined during an endoscopy.
Barrett's Esophagus is often categorized into short or long term disease segment, which
normally is based on the esophagus length that is affected. Short term Barrett segment
generally involves three centimeters or less of the esophagus. While long term Barrett segment
means more than three centimeters of the esophagus is damaged. Once Barrett's Esophagus is
diagnosed, the metaplastic lining in the patient’s esophagus does not progress further if the
patient is currently under the treatment of GERD. Thus, over time, in Barrett's disease the
length of the affected area remains the same.
It is believed that the process of metaplasia is an adaptive or protective response to the injury
of the lining. Nevertheless, the downside of metaplasia in Barrett's esophagus is that it carries a
small risk of increase rate of turning into cancerous. However, not all metaplasia cases carry the
risk of cancer. For example, intestinal metaplasia of the stomach can lead to cancer, but
intestinal metaplasia of the duodenum does not.
Barrett’s Esophagus Cancer
The disease Barrett's Esophagus often leads to a cancer known as “Adenocarcinoma”. This
cancer arises in the esophagus from the Squamous lining and is called Squamous Cancer or
“Carcinoma”.

8. Excessive smoking and alcohol ingestion are two of the most definite risk factors that can cause
Squamous Cancer and Adenocarcinoma. However, it is not clear yet, whether alcohol and
smoking increases the risk of having Adenocarcinoma, which makes GERD more severe or if
alcohol and smoking has a more direct effect in causing Squamous Cancer. Since the
Adenocarcinoma diagnoses have risen, the cancer in the Squamous cells have become less
common.
Adenocarcinoma Connected With Gastroesophageal Junction (Cardia)
Cancer caused in the Gastroesophageal Junction is also known as Cardia Cancer, since the area
where the esophagus and the stomach connect, is called Cardia. The cancer is speculated to be
connected with chronic GERD. Therefore, it is said that Cardia Cancer begins with short-term
Barrette segment. If the diagnosis of the cancer is made late, the tumor spreads beyond the
short term Barrett segment and might appear in the Cardia. However, this speculation remains
yet to be proven.
Dysplasia
When a change is observed in the cells’ lining of the esophagus, in which the cells show an
anomalous change in appearance and structure, this change is known as “Dysplasia”. When
these changes go from low grade to high grade Dysplasia, these cells begin to appear as
malignant like cancer cells. Unlike cancer, these cells stay in their place and do not invade any
tissues outside the lining. During endoscopy, Dysplasia can be identified when a series of
changes in the esophagus are observed. This occurs when Barrett’s Esophagus advances to the
stage of Barrett’s associated cancer.
Biomarkers
Due to the development of molecular techniques, changes referred as “Biomarkers”, have been
detected in biopsy samples before Dysplasia develops. The changes in these samples are similar
to cancer. Biomarkers include vicissitudes in the chromosomes and genes, DNA content of cells,
and in growth factors. Sometimes, these Biomarkers appear during or before the occurrence of

9. Dysplasia. The eventual goal is to find out, which patients among those with no Dysplasia or low
grade Dysplasia are likely to develop cancer or high grade Dysplasia.
The possibility of Biomarkers would stratify Barrett's in patients based on the risk of cancer. The
stratification would permit the doctors to do Biopsy more often in patients who are at minority
and have a greater risk of developing cancer.
Treatment of Barrett’s Esophagus
Medical Therapy (Non-Surgical)
The treatment of Barrett’s Esophagus is similar to GERD. The backbone of the treatment of
GERD is the suppression of the acid. For slight reflux symptoms, medicines that are sold over
the count are normally used, which range from H2 blockers to low dose drugs known as H-2
receptor antagonists or antacids.
Examples of H2 blockers include:
• Famotidine (Pepcid)
• Cimetidine (Tagamet)
For tenacious symptoms, higher drug doses of H-2 receptor antagonist are used, which include:
• Famotidine (Pepcid)
• Cimetidine (Tagamet)
• Ranitidine (Zantac)
• Nizatidine (Axid)
For symptoms that are strong, and include bleeding strictures such as GERD, these require
ongoing therapy. In such cases, PPIs (Proton Pump Inhibitors) are used. These include:
• Lansoprazole (Prevacid)
• Esomeprazole (Nexium)
• Rabeprazole (Aciphex)

10. • Pantoprazole (Protonix)
• Omeprazole (Prilosec, Zegerid)
Proton Pump Inhibitors are strong inhibitors to stomach acid secretion. These are very effective
in healing esophageal ulcers and esophageal inflammation (Esophagitis), which are prompted
by acid reflux. They also help in relieving heartburn. The PPIs have a couple of side effects too.
When these medications are stopped, acid reflux symptoms frequently recur, occasionally with
bigger intensity. The intensity of these symptoms occurs, because of the rebound of excessive
secretion of acid. This is a reaction brought on by secretion of extra acid.
Long-term exposure of PPIs is reported to develop Carcinoids (stomach tumors) in elder female
rats, but the same symptoms were not found in people who had used PPI for a period of over
15 years. In some cases, people developed fundic gland polyps (small benign polyps) in the top
half of their stomach. People whose age exceeded from 50 years, they had increased rate of hip
fracture and Vitamin B12 absorption became less. The PPI therapy must be decreased bit by bit
after anti-reflux surgery (Fundoplication), which is an operation for treating GERD.
Along with the drug therapy, some lifestyle changes are important, which include:
• Change in diet
• Losing weight
• Eating foods that contain less fat and acidic fluids
• No chocolates or caffeine
• Avoid alcohol
• No smoking
• Avoid fluids or food for a period of 2 hours before sleeping
• Upper body must be in an elevated position when you lie in bed
Adjunctive drug therapy that had been used in the past was for those patients whose
symptoms were not controlled, even with a double dose of PPI. These supplementary drugs
normally used are known as “Prokinetics”. This medicine works by speeding up the gastric

11. functions and emptying it, so that the stomach is left with fewer fluids or food. This means no
acid reflux.
Surgical Treatment
GERD connected with Barrett's Esophagus is sometimes cured by anti-reflux surgery. The
operation is called Fundoplication, and is performed to put a stop to the acid reflux. It is not yet
confirmed that this surgery has a decreased risk of esophagus cancer.
Patients with GERD who are possible candidates for Fundoplication must have:
• Severe complications, like recurring strictures
• A high dose of acid destroying medicines
Newer Treatments
Numerous ways have been developed for removing the anomalous dysplastic cells from the
esophagus lining or even primary cancers that affect the esophagus lining. These treatments
include:
1. Laser Therapy
A laser instrument is inserted in the esophagus that kills the anomalous cells. Due to
recent refinement of this technology, now it is called Photodynamic Therapy.
In this laser therapy, the patient is given some medicines that make their esophagus
lining cells sensitive to light for a certain period of hours, which causes gastroscopy.
During the procedure, the anomalous section of the esophagus is exposed to a laser
light. The cells, which have been sensitized due to the use of the medicine, are
destroyed during this procedure, which causes the nearby cells to multiply, and they
take place of the recently destroyed cells. The possible side effects of PDT include
narrowing of the esophagus, which causes a stricture that may affect swallowing. Some
people develop skin reactions due to the medicines.

12. 2. Epithelial Radiofrequency Ablation (EFA)
In this treatment, a radiofrequency energy coil is used, which leads to gastroscopy. In
this procedure, towards the anomalous section of the esophagus, a small coil is guided
in which heat energy is emitted and the anomalous cells are destroyed. Again, the
nearby normal cells multiply and take the place of the destroyed anomalous cells.
3. Argon Plasma Coagulation
In this treatment, a jet of argon gas is used to burn away the dysplastic cells. The gas is
combined with electric current charges.
4. Endoscopic Mucosal Resection (EMR)
In this procedure, the affected inner lining of esophagus is stripped off, which is done
via instruments that are passed down horizontal of a gastroscope.
Research is still being done out to find, which treatment is best, if a person is diagnosed
with Barrett's Esophagus. Regular checkup and endoscopy is required to track the
progress of this disease to stop it from turning into a cancer.
Jay Holt, in his book, has revealed his herbal secrets along with two formulas and one
special cure, which will help patients to get rid of Barrett’s Esophagus without any
surgical treatment or medicines. In his book, he explains how his life ultimately changed
when he did not receive a positive response from the doctors. He explains the process in

13. various steps, from which, with the help of the herbs, he got rid of his Barrett’s
Esophagus. The medicine helps in the following steps:
• Relief from high blood pressure and anxiety
• Gut pressure relieving
• Gut valve tightening
• Fat melting
• Quick relief from pain
• Cancer busting duo
Treatment of Barrett’s Esophagus from Several Herbs
Chinese Herbs for Tea
Both Western and Chinese herbs offer relief from Barrett’s Esophagus’s acid reflux. For
thousands of years, the use of Chinese herbs points to anecdotal evidence of their safety and
efficacy. All these Chinese and Western herbs are found in health food stores and various shops
but, doctors advice to obtain these herbs from apothecaries who specialize in Asian products or
from Oriental medicine doctors. Try not to take any of these Chinese herbs without consulting a
herbalist or natural health practitioner.
For a long period, doctors of oriental medicine have recommended to use of herbs in teas for
various diseases. The main point to remember is that, these herbs must be used fresh or dried.
Herbs sitting on the counter for a longer period may have lost their potency due to the
extended period of time they had been kept untouched.

14. • Licorice Root
Licorice root is an old herb, which has been used in China for centuries. It coats the esophagus
and the throat with mucilage that soothes any kind of burn. Mucilage is a thin mucus film,
which is created when the tea made with this herb encounters the digestive tract lining. Mucus
is produced when the compounds derived from licorice raise the prostaglandin levels and
create additional mucus that contributes in cellular healing.
• Green Tea
Green Tea contains natural antioxidants, which are called polyphenols. These antioxidants are
reported to protect the esophagus against cancer. Green tea also helps to stimulate the lower
esophageal sphincter, which prevents acid reflux from the stomach, back into the esophagus.

15. • Oldenlandia Diffusa
Oldenlandia Diffusa is another herb, which has been used by Chinese to treat the cancer of the
esophagus. This herb gets rid of the toxins that are present in the body and removes heat,
which emanates from the body. Chinese Rhizome and Rhubarb are also used for the treatment
of Barrett’s Esophagus.
• Herba Selaginella Doederleinii
Herba Selaginella Doederleinii stops the growth of tumors that lead to cancer in the esophagus.
This herb can also be incorporated in an herbal regimen during radiation and chemotherapy to
accelerate reduction of cancerous tumors.

16. References:
• http://www.jbbardot.com/barretts-esophagus-gerd-acid-reflux-cured-with-chinese-
herbs/
• http://www.medicinenet.com/barretts_esophagus/article.htm
• http://www.patient.co.uk/health/barretts-oesophagus-leaflet