Barrett’s oesophagus

Barrett’s oesophagus is a change in the lining of the oesophagus from normal multilayered squamous mucosa to single layered metaplastic columnar mucosa. 

It occurs in 2% of the population 

Causes of Barrett’s oesophagus:
  • Gastrooesophageal reflux disease – main cause -  Barrett’s develops in 5% of patients with GORD
  • Chemotherapy 
  • NSAID use 
  • Viral oesophagitis 
  • Congenital retardation syndromes 

Diagnosis is by endoscopy with biopsy 

The main complication associated with Barrett’s oesophagus is conversion to oesophageal adenocarcinoma.  This occurs in 5% men and 3% women with Barrett’s oesophagus.

Risk factors for conversion: 
  • Male gender 
  • White ethnicity
  • Length  affected >8cm 
  • Smoking 
  • Obesity 
  • Diet low in fruit and veg but high in fats 

  • Endoscopy with biopsy every 2 years 
  • Acid suppression therapy (usually PPIs)
  • ?Nissen fundiplication 

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