Barrett’s Oesophagus

What is Barrett’s oesophagus?

In Barrett’s oesophagus, tissue in the tube connecting your mouth and stomach (oesophagus) is replaced by tissue similar to the intestinal lining. Barrett’s oesophagus is commonly associated with acid reflux (see the section on causes below) and is a relatively common condition in Western countries. However, it is associated with an increased risk of developing oesophageal cancer. 

SYMPTOMS

Many people with Barrett’s oesophagus have no signs or symptoms. The tissue changes that characterise the disorder will not show any symptoms.  A patient may experience signs and symptoms due to reflux such as frequent heartburn, and Barrett’s oesophagus is then discovered on endoscopy.

WHEN to See a Doctor

Barrett’s oesophagus is an asymptomatic condition. Therefore, there are no specific signs and symptoms that would prompt someone to seek medical attention, unless you have been experiencing persistent reflux symptoms. In this scenario, the doctor will decide and further examine the patient with a gastroscopy to screen for Barrett’s oesophagus.

CAUSES

People who experience long-term gastroesophageal reflux disease (GERD) are often diagnosed with Barrett’s oesophagus. GERD is a chronic regurgitation of acid from the stomach into the lower oesophagus. A small percentage of people with GERD will develop Barrett’s oesophagus. As the oesophagus tries to heal itself, the cells can change to the type of cells found in Barrett’s oesophagus. Certain genes have been studied extensively and may explain why some people with Barrett’s oesophagus have a higher risk of developing cancer.

RISK FACTORS

There are known and established risk factors for Barrett‘s oesophagus, which include:

There are known risk factors, which include:

  • Individuals with GERD (e.g. chronic heartburn and acid reflux) that uses medication such as proton pump inhibitors to get symptom relief or does not get better with medication has an increased risk of Barrett’s oesophagus.
  • Barrett’s oesophagus can occur at any age but is more common in older adults.
  • Men are far more likely to develop Barrett’s oesophagus.
  • Obesity. Body fat around your abdomen further increases your risk.
  • Current or past smoking.
DIAGNOSIS

The diagnosis of Barrett’s oesophagus is confirmed using an endoscopy, where a special light through the endoscope allows the different linings to be identified. The length and extent of the suspected Barrett’s oesophagus is then recorded and classified using a system called the Prague Classification. Biopsies are taken to confirm the diagnosis and exclude cancer.

TREATMENT

Treatment involves treating the reflux causing Barrett’s oesophagus, and often involves the use of acid suppressants and lifestyle changes. This will be assessed and decided by the doctor.

Individuals with Barrett’s oesophagus require surveillance to make sure the segment of Barrett’s is not becoming abnormal (dysplastic) or cancerous. Individuals have to undergo an upper GI endoscopy once every 3 years.