Barrett's Oesophagus

Barrett's Oesophagus

Barrett's oesophagus is a condition in which the flat pink lining of the swallowing tube that connects the mouth to the stomach (oesophagus) becomes damaged by acid reflux, causing the lining to thicken and become red.


Symptoms


Signs and symptoms of Barrett's oesophagus include:

  • Difficulty swallowing food
  • Frequent heartburn and regurgitation of food consumed
  • Chest pain (less common)

Curiously, approximately half of the people diagnosed with Barrett's oesophagus report little if any symptoms of acid reflux. This is why you should discuss your digestive health with your doctor regarding the possibility of Barrett's oesophagus.


Causes


Between the oesophagus and the stomach is a critically important valve called the lower oesophagal sphincter (LES).  Over time, this valve may begin to fail, leading to acid damage of the oesophagus. This can then trigger a change in the cells lining the lower oesophagus, causing Barrett's oesophagus.


Barrett's oesophagus is associated with an increased risk of developing oesophagal cancer.

Although the risk of developing oesophagal cancer is small, it's ever so important to have regular checkups of the oesophagus to check for precancerous cells (dysplasia). 


If precancerous cells are discovered, they can be treated to prevent oesophagal cancer.

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Diagnosis & Treatment

Diagnosis


An Endoscopy is generally used to determine if you have Barrett's oesophagus. but what does that entail? 


This is a procedure where a lighted tube with a camera at the end (endoscope) is passed down your throat to check for signs of changing oesophagus tissue. 


Normal oesophagus tissue appears pale and glossy. In Barrett's oesophagus, the tissue appears red and velvety.


Your doctor will then remove some tissue (biopsy) from your oesophagus. The biopsied tissue will then be examined to determine the degree of change.


A doctor who specializes in examining tissue in a laboratory, known as a pathologist, will determine the degree of dysplasia in your oesophagus cells. 


Your tissue may be classified as followed:

  • No dysplasia - if Barrett's oesophagus is present but no precancerous changes are found in the cells.
  • Low-grade dysplasia - if cells show small signs of precancerous changes.
  • High-grade dysplasia - if cells show many changes and are about to change into oesophagal cancer.

Treatment


Treatment for Barrett's oesophagus depends on the extent of abnormal cell growth in your oesophagus. 


For no dysplasia, your doctor will likely recommend the following:

  • Periodic endoscopy to monitor the cells in your oesophagus. If your biopsies show no dysplasia, you'll probably have a follow-up endoscopy in one year and then every three to five years if no changes occur.
  • Medication and lifestyle changes can ease the signs and symptoms you're showing. Surgery to tighten the lower oesophagal sphincter that controls the flow of stomach acid may be an option as well. If this is the case, your doctor will talk you through the process.

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