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Barrett's Esophagus Causes & Symptoms

Increased Risk

The risk is increased in patients who reflux both stomach acid and bile (non-acidic fluid) into the esophagus. Neutralization of acid with antacid medications does not prevent injury to the esophagus from the non-acidic fluid. Therefore, even with suppression of acid production and decrease or elimination of heartburn with medical therapy, damage to the lining of the esophagus may continue in patients with bile (non-acidic fluid) reflux.

Bile causes injury to the lining of the esophagus and is a risk factor for developing Barrett’s esophagus. Anyone with long-standing (five or more years) reflux symptoms is at risk to have or develop Barrett's esophagus.


GERD is the main known risk factor for development of Barrett’s esophagus. The condition develops when GERD damages the squamous lining of the esophagus and the injury heals through a process called metaplasia, in which columnar cells replace squamous ones.


Common symptoms

  • Heartburn (burning sensation behind the breast bone)
  • Epigastric pain (upper abdominal pain)
  • Dysphagia (difficulty swallowing or the sensation that food is hanging up or not passing down into the stomach properly)
  • Regurgitation of food or liquids, particularly when bending over or laying down, associated with a bitter taste in the mouth

Atypical (uncommon) symptoms

  • Chest pain
  • Hoarseness
  • Cough
  • Pneumonia

The lining of the esophagus in patients with Barrett’s seems to be less sensitive to acid. Patients may notice an improvement in their reflux symptoms with the development of Barrett's esophagus, but the injury to the lining of the esophagus continues if the GERD is not treated. Any dysphagia (difficulty swallowing) in association with reflux symptoms is concerning and further assessment should be done to look for a stricture or tumor in the esophagus.