Barrett's oesophagus

If you suffer from longstanding heartburn you may develop Barrett's Oesophagus. This condition may lead to oesophageal cancer, but regular endoscopy and treatment can prevent this cancer developing. 

What is Barretts oesophagus ?

This is caused by the oesophagus being regularly exposed to regurgitating stomach acid. The damage causes the normal lining (squamous cell pattern) to be replaced by an intestinal-type (columnar pattern.) Barrett's oesophagus increases the risk of adenocarcinoma (cancer originating in glandular tissue) of the oesophagus, which is increasing in prevalence throughout the world. In view of its pre-malignant potential, Barrett's oesophagus warrants regular surveillance with upper endoscopy to ensure the pre-malignant changes are not progressing.

How common is Barrett's oesophagus?

It is estimated that up to 3 % of the population may have Barrett's and up to 40% of whom do not have any symptoms. In those people who have heartburn, up to 10% of people have Barrett's oesophagus.

How do you diagnose Barrett's oesophagus?

Barrett's oesophagus is diagnosed by looking at the oesophagus through an endoscope, whereby a tube with a video is inserted through the mouth. This is called a gastroscopy. The diagnosis is verified by taking samples from the oesophagus.

How is Barrett's oesophagus treated ?

Most people with Barrett's do not need to be treated apart from reducing the amount of acid in the oesophagus. This is achieved by acid inhibiting drugs such as omeprazole in the same way that acid reflux is treated.

Barrett's does need monitoring. This is done by regular gastroscopy, normally every 2 years. Samples of the oesophagus are taken, and providing these do not show any pre-cancerous changes, no specific treatment is required.

If the cells in the Barrett's change to become dysplastic (pre-cancerous), then recent studies have shown that removal of the cells can prevent a cancer developing. This treatment is called Radiofrequency ablation, otherwise known as the BarrX 'Halo' method. Dr Banks at University College London Hospital (UCLH) is currently involved in cutting edge research looking at early detection of pre-cancerous change in Barrett's and different treatments. The National BarrX Halo Research Registry is based at UCLH.