Oesophageal: Barrett's Oesophagus

Question 1

what is Barrett’s oesophagus?

Answer 1

metaplasia of the oesophageal epithelial lining

Question 2

what transition is occurring in Barrett’s oesophagus?

Answer 2

normal stratified squamous epithelium is replaced by simple columnar epithelium (glandular, present in the stomach)

Question 3

what is metaplasia?

Answer 3

abnormal reversible change of one cell type to another

Question 4

what are the vast majority of cases caused by?

Answer 4

chronic gastro-oespphageal reflux disease

Question 5

pathophysiology of Barrett’s oesophagus

Answer 5

epithelium of the oesophagus becomes damaged by the reflux of gastric contents, resulting in a metaplastic transformation. This in turn increases the risk of developing dysplastic and neoplastic changes.

Question 6

which part of the oesophagus is most commonly affected?

Answer 6

distal

Question 7

how is it diagnosed?

Answer 7

diagnosis relies on biopsy

Question 8

what are the risk factors?

Answer 8

caucasian
male 
>50 years
smoking 
obesity 
hiatus hernia
positive family history

Question 9

clinical features of BO

Answer 9

Hx of GORD
retrosternal chest pain 
excessive belching 
odynophagia 
chronic cough 
hoarseness

Question 10

what are the red flags for malignancy that are important to check for?

Answer 10

dysphagia 
weight loss
early satiety 
malaise
loss of appetite 
worsening dyspepsia despite PPI treatment