Barrett's Esophagus Facts

Diagnosis

There are two criteria that need to be met for a diagnosis of Barrett's esophagus. First, Barrett's esophagus tissue must have a typical appearance on an upper endoscopy exam (see below for description of exam). This appearance consists of tissue that is dark pink (often described as salmon-colored), which suggests that the intestinal-type tissue seen in Barrett's esophagus is present. Normal, unaffected esophagus tissue is whitish-pink. 

The second criterion comes from examination of biopsy samples of that dark pink tissue (which were taken during the endoscopy exam) under a microscope. These tissue samples must contain a special type of cell, known as a goblet cell, for a diagnosis of Barrett's esophagus to be confirmed. The physician evaluating the biopsy samples will also be able to determine how severe a patient's Barrett's esophagus is, and whether cancer is present.

How Barrett's esophagus is diagnosed: upper endoscopy and capsule endoscopy exams

Barrett's esophagus can only be diagnosed by viewing the lining of the esophagus through a procedure called an upper endoscopy - a non-surgical procedure performed using conscious sedation. The endoscope is a thin, flexible tube that is guided down the throat. The tube has a video lens and light at its tip that transmits images to a video monitor so the doctor can inspect the esophagus and capture pictures of the tissue. There are even newer, thinner endoscopes that can be passed through the nose.

There are also new, small capsules with built-in cameras that can be swallowed. As it passes through your digestive system, the camera transmits video to a recorder on your belt. Your doctor can look at the video to see if there are changes in the lining of the esophagus. It does not, however, allow for biopsy tissue samples to be taken.