Barretts Oesophagus Flashcards
define barretts oesophagus?
metaplasia of the lower oesophageal mucosa, with the usual squamous epithelium being replaced by columnar epithelium
how is BO catagorised?
- short (<3cm)
- long (>3cm)
what is the main problem with barretts oesophagus?
Barrett’s could progress to oesophageal adenocarcinoma
what are the risk factors of BO?
- GORD
- Males (7:1)
- Smoking
- Obesity
what is the epidemiology of BO?
- 1/10 adults have heart burn often
what are the presenting symptoms of BO?
- similar to GORD o Heartburn o Nausea o Water-brash (sour taste in the mouth) o Bloating o Belching o Burning pain when swallowing
investigations for BO?
- OGD and Biopsy
- this will show replacement of squamous epithelium with columnar epithelium
management plan for BO?
pre malignant changes
o Surveillance endoscopy and biopsy performed every 3-5 years
o High dose PPI
management plan for BO?
low grade dysplasia
o annual endoscopic surveillance is recommended
o confirmation from independent pathologist
management plan for BO?
High grade dysplasia
o Endoscopic resection
o Mucosal radiofrequency ablation
complications for BO?
- main complication is development of oesophageal adenocarcinoma
prognosis for patients with BO?
• Barrett’s oesophagus carries a 30-60 times higher risk of oesophageal adenocarcinoma than the general population
