Barrett's Oesophagus

Question 1

What is Barrett’s oesophagus.

Answer 1

A premalignant change from squamous cells to columnar cells in the lower oesophagus. (metaplasia).
It forms a segment of ‘columnar-lined oesophagus’ (CLO).
The length affected may be a few centimetres, to the entire oesophagus.

Question 2

What is Barrett’s oesophagus due to. (2)

Answer 2

It is secondary to chronic GORD - due to prolonged exposure to the refluxate of GORD. (a complication of GORD) - it is found in 10% of patients undergoing gastroscopy for reflux symptoms.
Central obesity is a risk factor.

Question 3

What is a complication of Barrett’s oesophagus.

Answer 3

Adenocarcinoma. However, this seems to relate to the severity and duration of the reflux, rather than the condition of Barrett’s oesophagus per se.
The risk of progression is low: 0.6-1.6% per year in patients with low grade dysplasia.

Question 4

What is the prevalence of Barrett’s oesophagus.

Answer 4

1.5-5% of the population.

Question 5

Who is Barrett’s oesophagus usually found in. (4)

Answer 5

It is more common in men (especially white).
Over 50.
Obese individuals.
It is weakly associated with smoking, but has no relation to alcohol intake.
It is found in 10% of patients undergoing gastroscopy for reflux symptoms.

Question 6

What is another common finding alongside Barrett’s oesophagus.

Answer 6

A hiatus hernia is almost always present.

Question 7

What percentage of GORD patients go on to develop Barrett’s oesophagus.

Answer 7

3-5%