Diagnosing Barrett’s esophagus is not easy. At the present time, it cannot be diagnosed on the basis of symptoms, physical exam, or blood tests. The only useful test is upper gastrointestinal endoscopy and biopsy.

In this procedure, a flexible tube called an endoscope, which has a light and miniature camera, is passed into the esophagus. If the tissue appears suspicious, then biopsies must be done. A biopsy is the removal of a small piece of tissue using a pincher like device passed through the endoscope. A pathologist examines the tissue under a microscope to confirm the diagnosis.

Looking for a medical problem in people who do not know whether they have one is called screening. Currently, there are no commonly accepted guidelines on who should have endoscopy to check for Barrett’s esophagus. Among the many reasons for the lack of firm recommendations about screening are the great expense and occasional risk of side effects of the test. Also, the rate of finding Barrett’s esophagus is low, and finding the problem early has not been proven to prevent deaths from cancer.

Many physicians recommend that adult patients who are over the age of 40 and have had gastroesophageal reflux disease (GERD) symptoms for a number of years have endoscopy to see whether they have Barrett’s esophagus. Screening for this condition in people who have no symptoms is not recommended.

Source: digestive.niddk.nih.gov – July 2008