If you’ve been suffering a long time from acid reflux, you may want to ask your doctor about a barium swallow test to screen for Barrett’s esophagus, a precancerous condition.

The damage that the acidic contents from the stomach causes to the inner lining of the esophagus can lead to cellular changes: a change in cells that create a risk factor for esophageal cancer.

A barium swallow is designed to detect anatomical changes such as cancer, but it cannot detect Barrett’s esophagus because Barrett’s is based strictly on biopsy findings.

If someone has had severe acid reflux over a long course of time, is it ever possible for the barium swallow to come up negative?

“A barium swallow can absolutely be normal despite severe reflux, because a barium swallow is made to show changes in anatomy in the esophagus and stomach,” says Alan Gingold, DO, a board certified gastroenterologist with the Digestive Healthcare Center of NJ.

“It will show masses or ulcers, but if there is no significant damage from the reflux, the barium swallow may appear normal.”

Barrett’s Esophagus

From normal cells to malignant cells.

About two percent of people with Barrett’s esophagus eventually develop esophageal cancer, which has a dismal five year survival rate of a little over 19 percent, according to the National Cancer Institute Surveillance and Epidemiology End Results Program.

Dr. Gingold explains, “Unfortunately, because Barrett’s esophagus is a pathological diagnosis — meaning that it is based on biopsy results, it cannot be followed by barium swallow studies.

“The only way to follow Barrett’s esophagus in patients with reflux is to do an EGD (esophagogastroduodenoscopy or upper endoscopy) every three to five years.”

Upper endoscopy. Shutterstock, Dmitry Kalinovsky

Dr. Gingold attributes his success to the extra time he spends with his patients. His areas of expertise include reflux disease, Barrett’s esophagus, capsule endoscopy, chronic liver disease and inflammatory bowel disease.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: ©Lorra Garrick