Barrett’s Oesophagus

Barrett’s oesophagus is a condition where the specialised cells lining at the lower end of the oesophagus (swallowing tube) transforms to become similar to the specialised cells lining the inside of the small intestine. It is usually caused by gastroesophageal reflux (GERD) from the stomach into the oesophagus, which damages the oesophageal cells resulting in chronic inflammation which then triggers the change in the cells lining the lower oesophagus. There are usually no additional symptoms in Barrett’s oesophagus.

Barrett’s oesophagus has been associated with an increased risk of developing oesophageal cancer, specifically adenocarcinoma. In some patients, the repeated cycle of reflux, injury and chronic inflammation induces even further change in the specialised oesophageal cells, leading to a pre-cancerous change known as dysplasia, which results in an increased risk of developing cancer

An endoscopy is usually carried out to diagnose Barrett’s Oesophagus. This is a procedure where a thin, flexible tube with a video camera (endoscope) is passed through your mouth to visualise your oesophagus, stomach and duodenum. This enables your doctor to visualise the lining of the lower oesophagus and a sample of tissue (biopsy) will be taken for testing.

Treatment is aimed at controlling symptoms of GERD with either medications such as anti-acid medicine (proton pump inhibitors) and/or surgery. Such treatments remove the cause for the change in oesophagus lining, but are not able to reverse the presence of Barrett’s oesophagus or completely remove the risk of cancer developing.

For patients with Barrett’s oesophagus and dysplasia (pre-cancerous change), certain therapies such as radiofrequency ablation (which uses heat), or photodynamic therapy (using light with certain chemicals) may be used to eliminate the dysplastic tissue (i.e. change of cell lining in the oesophagus) and reduce cancer risk.

If you have been diagnosed with Barrett’s oesophagus, the decision for endoscopic surveillance and treatment will be made after discussion on the potential risks and effectiveness of the treatments, in accordance with the recommended guidelines.