Barrett's Flashcards
Barrett’s oesophagus is a follow on from which disease?
Chronic GORD
What is the histological change in Barrett’s oesophagus?
Normal stratified squamous to columnar epithelium
What are some differentials of BO?
Oesophagitis
GORD
Adenocarcinoma
Gastritis
What are the risk factors for BO?
Over 50 GORD Obese Male White History of Ca or BO
How do we diagnosis BO?
Endoscopy and biopsy
What is the Prague clasification of BO?
There are two measurements used (in cm): the circumferential measurement (C) and the maximal measurement (M).
The M measurement measures how high up the longest ‘tongue’ goes.
The C measurement measure the top of the circumferential area.
Classifications will end up with labels such as C5M7.
What lengths are classed as “short” and “long”?
Short <3cm
Long 3cm or more
What are the different degrees of dysplasia?
No dysplasia
Indefinite
Low-grade
High-grade
How do we treat BO?
Non-dysplastic:
PPI
Radiofrequency ablation
Low-grade dysplasia:
Radiofrequency ablation w or w/o endoscopic mucosal resection
High-grade dysplasia:
As l-g with PPI and potentially Oesophagectomy
Which is the most effective treatment for reducing the risk of high-grade dysplasia and neoplastic progression?
PPIs
How often do we monitor patients with Barrett’s oesophagus?
This is debatable.
Roughly every 3-5 years with no dysplasia
If dysplasia is debatable then 6 months repeat and re-evaluate followed by a 12 month interval
Low-grade
12 months
High-grade
TREAT
What examinations do you do for Barrett’s oesophagus and what do you look for?
ABDO: w/l jaundice pallor candida Virchow's node scaphoid abdomen tenderness hepatomegaly previous scars
