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