Reflux testing and treatment

Diagnosing Barrett's esophagus

To help diagnose Barrett's esophagus, your physician will perform an upper endoscopy.

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Importance of early detection

Approximately 10 to 15 percent of gastroesophageal reflux disease (GERD) patients may progress to Barrett’s esophagus in their lifetime.1 Barrett’s esophagus is the primary risk factor for esophageal adenocarcinoma, a type of esophageal cancer.2-4

Barrett’s is more likely to occur in patients with certain risk factors, such as having frequent acid reflux symptoms, being obese, using tobacco, or having family history of Barrett’s or esophageal cancer.3,5 If you experience frequent GERD symptoms and have been regularly using medications to control heartburn for several years, speak to a gastroenterologist (GI) about screening for Barrett’s.

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How is Barrett’s esophagus diagnosed?

Barrett’s esophagus cannot be diagnosed by symptoms. Diagnosing Barrett’s is dependent on an upper endoscopy performed by a GI or surgeon.1

Endoscopy with biopsy procedure

An endoscopy is a procedure performed under sedation that allows the physician to directly visualize esophageal tissue and identify any abnormal tissue. An endoscope is a thin, flexible tube with a small camera attached. During the procedure, the endoscope is guided down the throat to inspect the esophagus and capture pictures of the tissue.

Your physician will also perform a biopsy and collect a small tissue sample for further examination if abnormal tissue is visualized. This sample will be used to determine if there is Barrett's esophagus and if there is dysplasia (abnormal cell growth) present in the lining of your esophagus.

If Barrett's esophagus is identified, the tissue sample will be classified into one of the following:6

  • Intestinal metaplasia without dysplasia: Barrett’s esophagus is present, but no precancerous changes are visible in the cells of your esophageal lining.
  • Low-grade dysplasia: Cells show early signs of precancerous changes that could lead to esophageal cancer.
  • High-grade dysplasia: Esophagus cells display a high degree of precancerous changes, thought to be the final step before esophageal cancer.

Stages of Barrett’s esophagus

Normal, healthy esophagus

Normal, healthy esophagus  


Esophagus affected by low-grade dysplasia (LGD)

Low-grade dysplasia

Esophagus damaged by erosive esophagitis (EE), prolonged acid exposure

Esophagus damaged by prolonged acid exposure

Esophagus affected by high-grade dysplasia (HGD)

High-grade dysplasia

Esophagus progressed to nonplastic Barrett's esophagus (NBDE)

Nondysplastic Barrett’s esophagus


Esophagus suffering esophageal adenocarcinoma

Esophageal adenocarcinoma

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Barrett’s esophagus risk assessment tool

Use this resource to assess your risk for Barrett’s esophagus and esophageal cancer.



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Information and resources on this site should not be used as a substitute for medical advice from your doctor. Always discuss diagnosis and treatment information including risks with your doctor. Keep in mind that all treatment and outcome results are specific to the individual patient. Results may vary.


Schlottmann F, Patti MG, Shaheen NJ. From Heartburn to Barrett's Esophagus, and Beyond. World journal of surgery. 2017;41(7):1698–1704.


De Jonge PJ, van Blankenstein M, Looman CW, Casparie MK, Meijer GA, Kuipers EJ. Risk of malignant progression in patients with Barrett’s oesophagus: a Dutch nationwide cohort study. Gut. 2010;59:1030–6.


Spechler S. et al. Barrett’s Esophagus. N Engl J Med 2014; 371:836–45.


Hvid-Jensen F, Pedersen L, Drewes AM, Sorensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365(15):1375–83.


Evans JA et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointestinal Endoscopy. 2012;76(6):1087–1094.


Mayo Clinic - Barrett's Esophagus - Diagnosis and Treatment - Accessed November 11, 2021.