The American Gastroenterologic Association advises that individuals who have had reflux symptoms (usually heartburn) for several years undergo upper endoscopy to determine if Barrett's esophagus is present and to assess for premalignant features.

Upper endoscopy is a simple, painless, low risk outpatient procedure requiring less than an hour. This is accomplished by insertion of a slim, flexible tube with a camera at its tip (endoscope) through the mouth into the esophagus. A computer and TV screen provide an image of your esophagus that allows the gastroenterologist to assess for inflammation (esophagitis) and Barrett's esophagus. The diagnosis of Barrett's esophagus is made by biopsy, or sampling of the esophageal lining.

At Johns Hopkins, biopsies are sent to the Division of Gastrointestinal Pathology and microscope slides are prepared from them. These are examined by gastrointestinal pathologists (physicians who specialize in the diagnosis of gastrointestinal diseases using microscopy).