The burn that climbs up behind your breastbone after a late meal is something most people wash down with an antacid and forget about by morning. But for the more than 60 million American adults living with gastroesophageal reflux disease (GERD), and the roughly 25 million who deal with heartburn every single day, those nightly flare-ups can cause real damage over the years. About 5% of people with chronic GERD eventually develop Barrett's esophagus, a precancerous change in the cells lining the esophagus. 

What makes the condition especially tricky is that Barrett's itself usually causes no symptoms of its own, so reflux can actually start feeling better even as your risk of esophageal cancer climbs. 

Continue reading to learn how long-term acid reflux affects the esophagus, what can be done for Barrett’s esophagus, and where to find the best GERD doctor in Los Angeles for treatment.

Barrett’s Esophagus: What to Know About Acid Reflux, GERD Damage, and Esophagus Scarring

Many people think of GERD as just an uncomfortable effect of a spicy meal, but stomach acid is not meant to wash over the esophagus day after day. The lining of the esophagus is more delicate than that of the stomach, so repeated exposure to acid and bile can slowly irritate and inflame the tissue. Over time, this can lead to erosive esophagitis, which means the lining begins to wear away and develop sores or ulcers. Some people can eventually develop esophageal strictures, which are areas of scar tissue that narrow the esophagus and make swallowing feel difficult or painful. When this happens, food can start feeling like it gets stuck in the chest, especially when eating bread or meat.

The damage from reflux usually happens slowly, which is why many patients do not realize how serious it has become. People often live with heartburn for 10 years or longer before seeking medical care because they normalize the symptoms or rely on over-the-counter antacids to control the burn. Unfortunately, acid suppression alone does not always stop reflux from damaging tissue underneath the surface. GERD can also affect areas outside the esophagus. Signs that reflux may be reaching beyond the stomach and causing ongoing injury throughout the upper digestive tract and airway include: 

  • Chronic cough
  • Hoarseness
  • Sore throat
  • Worsening asthma
  • Dental erosion 

What is Barrett's Esophagus?

Chronic acid reflux can damage the esophagus when stomach acid repeatedly irritates the tissue. Barrett's esophagus is a condition that develops after years of chronic acid exposure. This condition occurs when the normal esophageal lining cells are replaced by intestinal-type cells. This change is the body's attempt to protect itself from repeated acid injury. While the new cells are more resistant to stomach acid, they also carry a higher risk of turning into cancer over time. Barrett's esophagus is considered a precancerous condition because it increases the likelihood of developing esophageal adenocarcinoma.

One of the most concerning aspects of Barrett's is that reflux symptoms can seem to improve after the cellular changes occur. Because the new lining tolerates acid better, some patients notice less burning and assume the problem has been resolved. In reality, the reflux may still be causing silent damage that continues to raise cancer risk.

Who is at Risk of Developing Barrett’s Esophagus?

Research finds that about 5% of patients with long-standing GERD eventually develop Barrett's esophagus. Certain groups face a higher risk, including white men over age 50, smokers, people with obesity, and patients with hiatal hernias or a family history of esophageal cancer. 

What Are the Symptoms of Barrett's Esophagus?

Barrett's esophagus usually does not cause noticeable symptoms of its own. Most patients discover it during testing for chronic GERD rather than from a new symptom that points directly to the condition. This is one reason Barrett's can go undetected for years. 

Even though Barrett's itself is often silent, certain symptoms should never be ignored: 

  • Difficulty swallowing
  • Painful swallowing
  • Unexplained weight loss
  • Vomiting blood
  • Black stools
  • Anemia 
  • Persistent reflux symptoms that continue despite proton pump inhibitors

These are all symptoms that can be associated with advanced esophageal damage or esophageal cancer. If medications no longer control heartburn or regurgitation, the best GERD doctor in Los Angeles will usually recommend an upper endoscopy to look for complications such as severe inflammation, strictures, or Barrett's esophagus. 

How is Barrett's Esophagus Diagnosed and Monitored?

Barrett's esophagus can be diagnosed with an upper endoscopy, also called an EGD. During this procedure, a flexible camera is inserted through the mouth to examine the esophagus, stomach, and upper small intestine. Barrett's tissue often appears as a salmon-colored lining that looks different from the normal pale tissue of the esophagus. Additionally, small tissue samples called biopsies are taken and examined under a microscope to confirm intestinal metaplasia. The best gastroenterologists in Los Angeles also use the Prague C&M classification system to measure the length and extent of the Barrett's segment.

What Are the Treatment Options for Barrett's Esophagus?

Treatment for Barrett's esophagus focuses on controlling reflux and reducing the risk of cancer progression. For patients without dysplasia, the first step is usually aggressive acid suppression with proton pump inhibitors. Lifestyle changes also play an important role. Weight loss, avoiding meals late at night, elevating the head of the bed, and limiting trigger foods can help reduce reflux episodes and decrease ongoing injury to the esophagus. 

When is Surgery Necessary for GERD or Barrett's Esophagus?

Some patients continue having severe reflux despite maximum therapy, while others cannot tolerate long-term proton pump inhibitors because of side effects or ongoing symptoms. In these cases, anti-reflux surgery can help. The most common procedure is laparoscopic Nissen fundoplication, which strengthens the barrier between the stomach and esophagus. Many patients also require hiatal hernia repair at the same time because the hernia can worsen reflux by allowing stomach contents to move upward more easily.

Where to Find the Best GERD Doctor in Los Angeles for Barrett’s Esophagus Treatment

Living with constant reflux can slowly change the esophagus in ways that are easy to miss until the damage becomes harder to reverse. The good news is that Barrett’s esophagus and severe GERD can be managed with medications and minimally invasive procedures.

As the leading expert in minimally invasive bariatric, foregut and complex general surgery, and Medical Director of the Bariatric Surgery and Metabolic Weight Loss Center of Providence Saint John’s Hospital, Dr. Danny Shouhed leads our team with advanced evaluation, endoscopic surveillance, and surgical treatment options for patients dealing with chronic reflux, Barrett’s esophagus, hiatal hernias, and complex GERD that no longer responds to medication. 

Ready to see the best gastroenterologist in Los Angeles for GERD and stop reflux from interfering with your health, sleep, and peace of mind?