Barrets Oesophagus Flashcards
What is Barrett’s oesophagus?
Columnar metaplasia of the distal oesophagus
What cells line the oesophagus?
Squamous epithelial cells
What do cells turn from and to in Barrett’s oesophagus?
From squamous epithelium
To columnar epithelium
What is metaplasia?
Transformation of 1 mature cell type into another
What is the typical person who presents with Barrett’s oesophagus?
Caucasian male
What causes Barrett’s oesophagus?
GORD
What is Barrett’s oesophagus a precursor of?
Adenocarcinoma
What are the risk factors of Barrett’s oesophagus? (7)
• Long standing gastro-oesophageal reflux
• Male sex (male-to-female ratio 2:1)
• Caucasian ethnicity
• Increasing age
• Obesity
• Smoking
• Family history
Where is metaplasia most common?
Transformation zones where one cell type meets another
What are the signs and symptoms of Barrett’s? (6)
• Heartburn
• Regurgitation
• Chest discomfort
• Dyspepsia
• Nausea and/or vomiting
• Dysphagia (suggestive of stricture or malignancy in context of BO and reflux)
How is Barrett’s diagnosed?
Endoscopy and confirmed with biopsies
Where should the squamo-columnar junction (z line) occur in a normal oesophagus and where is it found in Barrett’s?
Normal = within 1cm of the GOJ
BO = >1cm above the GOJ
What is the main treatment of Barrett’s?
PPIs
What is the mechanism of action of PPIs?
prevent acid production within the stomach through inhibition of H+/K+ ATPases in parietal cells.
Why is endoscopic surveillance recommended in patients with Barrett’s?
High risk of oesophageal adenocarcinoma
