Understanding Barrett's Esophagus

The Five Layers of the Esophageal Lining

 

histology

 

There are five layers to the esophageal lining:

  • The top layer is the Esophageal Epithelium (EP) and is about ½ millimeter in depth. This is the layer that changes to intestinal metaplasia when someone has Barrett’s.  Barrett’s is approximately ½ millimeter in depth.
  • The next layer is the Lamina Propria (LP). This is the support structure to the esophageal epithelium. If Barrett’s progresses to cancer, we see intramucosal cancers in the Lamina Propria.
  • The next layer is the Muscularis Mucosa (MM). These three layers (EP, LP, and MM) make up the Esophageal Mucosa. The total depth of these three layers is approximately 1 millimeter. This depth is important when understanding the treatment of the disease, as this should be the area to treat when removing all of Barrett’s tissue.
  • The next layer is the Sub Mucosa (SM). If any therapies encroach into this layer, it raises concern for complications. This will become apparent when discussing the treatment therapies for Barrett’s.
  • The last layer is the Muscularis Propria (MP), which is the outer muscle layer of the esophagus. If an esophagus has to be removed or resected, it is to this level.

Next Page: How Reflux Affects the Esophageal Lining

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