Barrett's oesophagus Flashcards
What is Barret’s oesophagus?
prolonged exposure to refluxate of GORD leads to mucosal inflammation + erosion, leads to replacement of mucosa with metaplastic columnar epithelium
Metaplastic change: Squamous to Columnar
Describe the aetiology of Barret’s oesophagus
Reflux occurs if the cardiac sphincter is not working (mostly idiopathic)
Hiatus hernia make GORD more likely
List 4 risk factors for Barret’s oesophagus
Acid reflux / GORD
Increased age
White ethnicity
Male
Describe the epidemiology of Barret’s oesophagus
1/10 adults have heart burn daily
3-5% of people with GORD develop Barrett’s oesophagus
List 7 symptoms of Barret’s oesophagus
Heartburn Nausea Water-brash (sour taste in mouth) Bloating Belching Burning pain when swallowing Regurgitation
List 3 signs of Barret’s oesophagus
Wheeze
Dyspnoea
Cough
What investigations should be performed in Barrett’s oesophagus?
OGD + Biopsy
Shows replacement of squamous with columnar epithelium
How is non dysplastic Barrett’s oesophagus managed?
PPI + surveillance (endoscopy every 2 years) Radiofrequency ablation (if high risk)
How is low grade dysplastic Barrett’s oesophagus managed?
Radiofrequency ablation
+ PPI
How is high grade dysplastic Barrett’s oesophagus managed?
Radiofrequency ablation + PPI +/- endoscopic mucosal resection
2nd line: oesophagectomy
List complications of Barrett’s oesophagus
Oesophageal adenocarcinoma
Dysplasia
What is the prognosis in Barrett’s oesophagus?
30-60X higher risk of oesophageal adenocarcinoma than general pop
Most DONT develop oesophageal adenocarcinoma
5-10% of Barrett’s develop adenocarcinoma over 10-20 years