tel: 0207 132 1440 email: firstname.lastname@example.org
Barrett’s oesophagus is a change that happens at the lower end of the gullet. It means that the cells lining the inside of the oesophagus have changed to be more like those of the stomach (so called ‘columnar-lined epithelium’, because the cells become rectangular and stacked in columns, rather than the flat, horizontal cells that are usually seen in the oesophagus).
Almost certainly Barrett’s oesophagus happens because of long-standing gastro-oesophageal reflux. It is more common in people with a hiatus hernia, in men, and in overweight people.
Barrett’s oesophagus per se does not cause symptoms. The most likely symptoms are heartburn and regurgitation cause by the underlying GORD. Interestingly, a proportion of people with Barrett’s oesophagus have never had any reflux symptoms (and have so-called 'silent reflux'. Their Barrett's oesophagus is diagnosed by chance due to an endoscopy for other reasons).
Your chances of having Barrett’s oesophagus are much less than your chances of not having it. Approximately 10% of people with persistent reflux symptoms have Barrett’s oesophagus. This risk is considered high enough to make it important to have persistent reflux symptoms checked out by a doctor.
Barrett’s oesophagus is diagnosed by a camera examination (gastroscopy, otherwise called upper GI endoscopy, or OGD). The diagnosis can usually be made visible, but confirmation biopsy samples must also be taken.
The importance of Barrett’s oesophagus is that there is a risk of it developing into oesophageal cancer. The risk of this happening has been a matter of debate, but is probably small and in the region of 0.3% per year (3 in 1000 people with Barrett’s develop a cancer every year).
Stopping smoking, and drinking alcohol in moderation is likely to help, as is losing weight if you have a few extra pounds around the waist.
If you have Barrett’s oesophagus you should take proton pump inhibitor tablets (PPIs, e.g. omeprazole, lansoprazole). This is because acid reflux is thought to cause Barrett’s, and so reduction in acid appears to be a logical treatment.
Finally, it is often important to undergo regular ‘surveillance’ endoscopy examinations.
In many people with Barrett’s oesophagus regular endoscopy is conducted for surveillance (keeping an eye on it) purposes. Ideally, this is not with an aim to identify cancer early, but rather to detect early changes (dysplasia) that are associated with an increased risk of turning into cancer. To do this properly it should be done by an expert endoscopist who is experienced at surveying Barrett’s oesophagus, and with good equipment (a high-definition gastroscope). If these abnormalities are detected, they can be treated using endoscopic techniques called endoscopic mucosal resection and radio frequency ablation.
Surveillance is usually done every 2 years, or sometimes more frequently in certain cases.
The doctors at Gastroenterology at Canary Wharf can offer expert, experienced advice, diagnosis and treatment of Barrett's oesophagus. Please call our secretarial team on 020 3727 0935 or email on email@example.com to make an appointment.
Tel: 020 7132 1440 email: firstname.lastname@example.org
Post: Professional Medical Management Services, Freepost