Barrett's oesophagus Flashcards

1
Q

What is Barret’s oesophagus?

A

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

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2
Q

Describe the aetiology of Barret’s oesophagus

A

Reflux occurs if the cardiac sphincter is not working (mostly idiopathic)
Hiatus hernia make GORD more likely

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3
Q

List 4 risk factors for Barret’s oesophagus

A

Acid reflux / GORD
Increased age
White ethnicity
Male

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4
Q

Describe the epidemiology of Barret’s oesophagus

A

1/10 adults have heart burn daily

3-5% of people with GORD develop Barrett’s oesophagus

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5
Q

List 7 symptoms of Barret’s oesophagus

A
Heartburn  
Nausea  
Water-brash (sour taste in mouth)  
Bloating  
Belching  
Burning pain when swallowing  
Regurgitation
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6
Q

List 3 signs of Barret’s oesophagus

A

Wheeze
Dyspnoea
Cough

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7
Q

What investigations should be performed in Barrett’s oesophagus?

A

OGD + Biopsy

Shows replacement of squamous with columnar epithelium

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8
Q

How is non dysplastic Barrett’s oesophagus managed?

A
PPI + surveillance (endoscopy every 2 years)
Radiofrequency ablation (if high risk)
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9
Q

How is low grade dysplastic Barrett’s oesophagus managed?

A

Radiofrequency ablation

+ PPI

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10
Q

How is high grade dysplastic Barrett’s oesophagus managed?

A

Radiofrequency ablation + PPI +/- endoscopic mucosal resection
2nd line: oesophagectomy

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11
Q

List complications of Barrett’s oesophagus

A

Oesophageal adenocarcinoma

Dysplasia

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12
Q

What is the prognosis in Barrett’s oesophagus?

A

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

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