barrett's oesophagus

Question 1

Barrett’s Oesophagus

Answer 1

Barrett’s oesophagus= metaplasia of the lower oesophageal mucosa from squamous epithelium to columnar epithelium. It increases risk of oesophageal adenocarcinoma, estimated at 50-100 fold.
There are no screening programs for Barrett’s - it’s typically identified when patients have an endoscopy for evaluation of upper gastrointestinal symptoms such as dyspepsia.

Question 2

Barrett’s Oesophagus: Risk Factors

Answer 2

gastro-oesophageal reflux disease (GORD) - reflux symptoms after development Barrett’s oesophagus.
male gender (7:1 ratio)
smoking
central obesity

Question 3

Barrett’s Oesophagus: Symptoms

Answer 3

asymptomatic or GORD symptoms

Question 4

Barrett’s Oesophagus: Investigations

Answer 4

endoscopy for evaluation of upper gastrointestinal symptoms such as dyspepsia.

Question 5

Barrett’s Oesophagus: Management

Answer 5

• high-dose proton pump inhibitor + endoscopic surveillance with biopsies every 3-5 years
• dysplasia requires endoscopic intervention. Options include:
• radiofrequency ablation: first-line treatment, particularly for low-grade dysplasia
• endoscopic mucosal resection