Barrett’s Oesophagus Flashcards
What does Barrett’s refer to?
Metaplasia of the lower oesophageal mucosa, with squamous epithelium replaced by columnar epithelium
Barrett’s oesophagus is a condition where the normal squamous cells of the esophagus are replaced by columnar cells, which can lead to increased cancer risk.
What is the increased risk of oesophageal adenocarcinoma associated with Barrett’s?
50-100 fold
This significant increase highlights the importance of monitoring and managing Barrett’s oesophagus.
How is Barrett’s typically identified?
During an endoscopy for evaluation of upper gastrointestinal symptoms such as dyspepsia
There are no specific screening programs for Barrett’s.
What are the two subtypes of Barrett’s based on segment length?
Short (<3cm) and long (>3cm)
The length of the affected segment is important in assessing the risk of metaplasia.
What is the overall prevalence of Barrett’s oesophagus estimated to be?
Approximately 1 in 20
It is also identified in up to 12% of those undergoing endoscopy for reflux.
What histological features may the columnar epithelium in Barrett’s resemble?
Cardiac region of the stomach or small intestine (e.g. goblet cells, brush border)
The histological appearance can help distinguish Barrett’s from other conditions.
What is the single strongest risk factor for Barrett’s?
Gastro-oesophageal reflux disease (GORD)
GORD causes chronic irritation to the esophagus, leading to metaplasia.
What is the male to female ratio for Barrett’s oesophagus?
7:1
This suggests a significant gender predisposition towards developing Barrett’s.
List other risk factors for Barrett’s oesophagus.
- Smoking
- Central obesity
While these factors increase the risk, alcohol does not appear to be an independent risk factor.
Is Barrett’s oesophagus typically symptomatic?
No, Barrett’s itself is asymptomatic
Patients may often experience coexistent GORD symptoms.
What is a common management strategy for Barrett’s?
High-dose proton pump inhibitor
This treatment is common but has limited evidence for preventing progression to dysplasia.
What is the recommended endoscopic surveillance for patients with metaplasia?
Every 3-5 years
This is recommended for patients with metaplasia but without dysplasia.
What should be done if dysplasia of any grade is identified?
Endoscopic intervention is offered
Options include radiofrequency ablation and endoscopic mucosal resection.
What is the preferred first-line treatment for low-grade dysplasia in Barrett’s?
Radiofrequency ablation
This method is favored due to its effectiveness in treating dysplastic lesions.
What does Barrett’s refer to?
Metaplasia of the lower oesophageal mucosa, with squamous epithelium replaced by columnar epithelium
Barrett’s oesophagus is a condition where the normal squamous cells of the esophagus are replaced by columnar cells, which can lead to increased cancer risk.
What is the increased risk of oesophageal adenocarcinoma associated with Barrett’s?
50-100 fold
This significant increase highlights the importance of monitoring and managing Barrett’s oesophagus.
How is Barrett’s typically identified?
During an endoscopy for evaluation of upper gastrointestinal symptoms such as dyspepsia
There are no specific screening programs for Barrett’s.
What are the two subtypes of Barrett’s based on segment length?
Short (<3cm) and long (>3cm)
The length of the affected segment is important in assessing the risk of metaplasia.
What is the overall prevalence of Barrett’s oesophagus estimated to be?
Approximately 1 in 20
It is also identified in up to 12% of those undergoing endoscopy for reflux.
What histological features may the columnar epithelium in Barrett’s resemble?
Cardiac region of the stomach or small intestine (e.g. goblet cells, brush border)
The histological appearance can help distinguish Barrett’s from other conditions.
What is the single strongest risk factor for Barrett’s?
Gastro-oesophageal reflux disease (GORD)
GORD causes chronic irritation to the esophagus, leading to metaplasia.
What is the male to female ratio for Barrett’s oesophagus?
7:1
This suggests a significant gender predisposition towards developing Barrett’s.
List other risk factors for Barrett’s oesophagus.
- Smoking
- Central obesity
While these factors increase the risk, alcohol does not appear to be an independent risk factor.
Is Barrett’s oesophagus typically symptomatic?
No, Barrett’s itself is asymptomatic
Patients may often experience coexistent GORD symptoms.
