Barrett's oesophagus

Question 1

What is Barrett’s oesophagus?

Answer 1

An oesophagus in which any part of the distal squamous epithelial lining has been replaced by metaplastic columnar epithelium

Question 2

What are the risk factors for Barrett’s oesophagus?

Answer 2

Longstanding GORD
Obesity
Smoking
Hiatus hernia
Increasing age

Question 3

What is the presentation of Barrett’s oesophagus?

Answer 3

Same as in GORD:
- Pain in upper abdomen and chest
- Heartburn
- Acid taste in the mouth
- Bloating
- Belching

Question 4

What is the two week wait referral criteria for those with GORD?

Answer 4

Dysphagia
Over 55 with weight loss and any of the following:
- upper abdominal pain
- reflux
- dyspepsia

Question 5

What is the gold standard investigation for diagnosis of Barrett’s oesophagus?

Answer 5

OGD

Question 6

What is the management of Barrett’s oesophagus?

Answer 6

<3cm
- Repeat OGD every 3 to 5 years
>3cm
- Repeat OGD every 3-2 years

Question 7

What is the management of patients with dysplasia?

Answer 7

Endoscopic ablation therapy

Question 8

What is the primary complication of Barrett’s oesophagus?

Answer 8

Progression to oesophageal adenocarcinoma