Barrett's Oesophagus

Question 1

What are the diagnostic criteria for Barrett’s oesophagus?

Answer 1

Endoscopic evidence of columnar lining in oesophagus above gastroesophageal junction
Histological evidence of intestinal metaplasia (goblet cells) in biopsy from columnar epithelium

Question 2

What causes Barrett’s oesophagus?

Answer 2

Chronic GORD leads to repetitive mucosal injury, causing cellular proliferation and eventual re-epithelialisation by columnar epithelium

Question 3

What is Barrett’s oesophagus a key risk factor for?

Answer 3

Oesophageal adenocarcinoma

Question 4

Is Barrett’s oesophagus characterised by metaplasia or dysplasia?

Answer 4

Either: metaplasia first but same conditions can lead to dysplasia of varying grades

Question 5

What are the criteria for identifying dysplasia?

Answer 5

Surface maturation of glandular mucosa
Crowding, change in shape and complexity of glands
Gland fusion
Cytological changes (nuclear atypia, loss of polarity)