BARRETT’S ESOPHAGUS

Question 1

Definition (5)

Answer 1

• Late complication of GERD
• Columnar intestinal metaplasia of the squamous epithelium with goblet cells
• Salmon pink velvety mucosa
• 1% risk of Adenocarcinoma
• Starts as metaplasia —> low-grade dysplasia —> high-grade dysplasia —> invasive

Question 2

Endoscopic surveillance- Metaplasia

Answer 2

Rescope every 2-3 years

Question 3

Endoscopic surveillance- Low-grade Dysplasia

Answer 3

Repeat endoscopy with biopsy every 1cm within 6 months while on high dose PPI

Question 4

Endoscopic surveillance- High-grade Dysplasia (4)

Answer 4

• If endoscopically visible lesion —> resect for histology
• If not visible —> high dose PPI and repeat biopsy
• Positive endoscopic ultrasound
• Radiofrequency ablation is the treatment of choice following removal of modular lesions