Barrett’s Oesophagus

Barrett's oesophagus is a change in the tissue lining your oesophagus, the tube in your throat that carries food to your stomach.

Overview
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What is Barrett’s Oesophagus?

The oesophagus (or esophagus) is part of the digestive system, and is a long, muscular tube that connects your mouth to your stomach. It is also known as the gullet or food pipe.

Barrett’s oesophagus occurs where the normal cells lining of the oesophagus have changed and have been replaced with abnormal cells. In some people, the cells of Barrett’s oesophagus become more abnormal. This is known as dysplasia, which is a pre-cancer.

In the UK, a small number of people (3-13%) with Barrett’s oesophagus will develop oesophageal cancer. This is a rare type of cancer called oesophageal adenocarcinoma.

Dysplasia

People with high-grade dysplasia in Barrett’s oesophagus have a high risk of getting oesophagus cancer. The pre-cancerous cells of dysplasia are classified into 2 grades, low grade and high grade, based on how abnormal the cells appear under the microscope in a biopsy.

People with low-grade dysplasia in Barrett’s oesophagus have an increased risk of oesophagus cancer but most do not go on to get this cancer.

If you have been diagnosed with Barrett’s oesophagus, then your gastroenterologist (GI specialist) may recommend that you have regular examinations to watch out for signs of dysplasia.

What causes Barrett’s Oesophagus?

The main cause of Barrett’s oesophagus is acid reflux. This occurs when some acid or bile in the stomach flows back up into the oesophagus and damages the lining over time. Acid reflux is strongly linked to Gastro-Oesophageal Reflux Disease (GORD or GERD)

Around 10% of people with long-term GORD will develop Barrett’s oesophagus.

While Barret’s oesophagus can affect both men and women, it is twice as common in men. It is rare in children. Other risk factors include:

  • Age over 50
  • White race
  • Long-term GORD (over 5 years)
  • Obesity (especially high levels of belly fat)
  • A family history of the condition
  • Smoking
  • High alcohol intake

Symptoms of of Barrett’s Oesophagus

Many of the associated symptoms of Barrett's oesophagus are similar to other digestive disorders. So many people don’t look for medical treatment until this disorder has developed into an advanced condition. Most people with Barrett’s do not experience any symptoms at all.

The main symptoms of Barrett's oesophagus include:

Diagnosis of Barrett’s Oesophagus

To determine if you have Barrett’s oesophagus, your gastroenterology doctor will start by asking you to provide your medical history. If you have many factors that increase your chances of developing Barrett’s oesophagus, your doctor will recommend diagnostic tests for Barret’s oesophagus:

The two main tests to diagnose this condition are:

  • Upper Endoscopy – (gastroscopy) In this procedure, a thin, flexible tube, called an endoscope, will be inserted down your oesophagus, stomach and the first part of the small intestine (duodenum). It will allow your gastroenterologist to see changes in the lining of your oesophagus.
  • Endoscopic biopsy –In this test, a small amount of cell tissue is removed from the lining of the oesophagus during the endoscopy and sent to a laboratory to be checked for cellular changes.

Same-day diagonostic procedures at OneWelbeck

The new Digestive Health Centre at OneWelbeck in London can provide you with fast, high-quality-diagnostic services to investigate the symptoms of Barrett’s Oesophagus. Most of these services can be conducted as day-case procedures, without the need for overnight stay. It may take a few days for the results of laboratory tests from a biopsy to become available.

At OneWelbeck, patients are cared for by a multidisciplinary team of specialist professionals who have access to the latest medical technology to diagnose and manage the condition.

Monitoring Barrett’s Oesophagus

If you have been diagnosed with Barrett’s oesophagus, your GI specialist may recommend that you have an endoscopy (gastroscopy) and biopsy on a regular basis to watch out for signs of cancer development.

Experts do not agree on how frequent these monitoring procedures should be performed. At OneWelbeck, your specialist will discuss your diagnosis with you, and advise you how often you should be monitored based on your individual circumstances.

Treatment of Barrett’s Oesophagus

There are various ways to manage Barrett’s oesophagus. These include medications, endoscopic therapies, surgery and lifestyle changes. Your treatment will depend on how severe your cellular changes appear to be, as well as your overall health. The main aim of treatment is to reduce acid reflux, control symptoms and prevent the development of oesophageal cancer.

Medications

If you have Barrett’s Oesophagus, your doctor will usually advise you to take acid-suppressing medications.

The most commonly used medications to treat Barrett’s oesophagus include Proton Pump Inhibitors (PPI), such as omeprazole and lansoprazole. These treatments work by reducing acid production in the stomach. This action naturally reduces the acid from refluxing back into the oesophagus.

Endoscopy treatments

Over the past 20 years, the rapid development of endoscopic technology means that safe and effective treatments are available for treating dysplasia and early cancer in Barrett’s oesophagus. Other treatments include endoscopic mucosal resection, radiofrequency ablation and cryotherapy.

Surgery

Doctors can also treat the tissue changes linked to Barrett’s oesophagus with surgery. If your gastroenterologist thinks you may benefit from surgery, they will refer you to a surgeon to discuss your treatment options.

Lifestyle Changes 

Making certain lifestyle changes can help to reduce the amount of acid in your stomach, and the risk of Barrett’s oesophagus. These changes include:

  • Maintaining a healthy weight
  • Avoiding tight-fitting clothes
  • Giving up smoking
  • Avoiding stooping, bending or lying down after eating
  • Raising the head of your bed by 6 to 8 inches

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Frequently Asked Questions

Can Barrett’s oesophagus be cured?

Recent studies have shown that under the right conditions, Barrett’s oesophagus can be made to “regress” – return to a normal condition. A new procedure called ablation therapy involves suppression of stomach acid and treatment of the oesophageal lining.

Several treatment sessions of ablation therapy may be required to effectively regress Barrett’s oesophagus. However, some Barrett’s cells may still remain in the body after this treatment. It is unknown whether ablative therapy reduces the risk of cancer. Speak to your GI specialist for more information.

How can I prevent Barrett’s from progressing to cancer?

Although there are various methods to treat Barrett’s oesophagus, it is important to have regular check-ups by trained gastroenterologists using biopsies or endoscopy procedures. These surveillance procedures can help doctors to identify, monitor and reduce the risks of oesophageal cancer, before and after treatment.

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Condition overview
Barrett’s Oesophagus

Causes

Acid reflux, GORD, Obesity

Symptoms

Difficulty swallowing, heartburn, chest pain, vo...

Tests

Gastroscopy, Endoscopic biopsy

Treatment

Medications, Endoscopy treatment, surgery

Barrett’s Oesophagus Specialists

We have brought together a group of leading colorectal and general surgeons and gastroenterologists to create our Digestive Health team. With over 300 years of combined experience, these expert clinicians are the best in their field and are all focused on delivering the very best patient care.

Earliest availability 19 Dec
Bookings are avaliable

Dr Rami Sweis

Consultant Gastroenterologist

Specialist expertise: Gastroenterology, Colonoscopy, Irritable Bowel Syndrome, Oesophageal Dilatation, Stricture Dilatation, Endoscopic Mucosal Resection, Per-Oral Endoscopic Myotomy, HALO Radiofrequency Ablation, Small Intestinal Bacterial Overgrowth, High Resolution Manometry, Impedance pH Monitoring, Wireless pH Monitoring, Oesophageal Physiology, Behavioural Modification Therapy, Trans-Oral Incisionless Fundoplication, Dysphagia, Heartburn, Acid Reflux, Investigation and Management of Reflux, Barrett’s Oesophagus, Achalasia, Eosinophilic Oesophagitis, Belching Disorders, Gastroparesis, Abdominal Pain, Bloating, Constipation, Diarrhoea, Anaemia, Rectal Bleeding, Rumination Syndrome.

Dr Matthew Banks

Consultant Gastroenterologist

Specialist expertise: Acid Reflux, Barrett’s Oesophagus, Colonoscopy, Early Cancer Detection, Endoscopic Ultrasound, Gastroenterology, Upper Gastrointestinal Disorders, Gastrointestinal Medicine, Gastrointestinal Specialty, Endoscopy, Bowel Cancer Screening, Irritable Bowel Syndrome, Diarrhoea, HALO Radiofrequency Ablation, Endoscopic Submucosal Dissection, Per-Oral Endoscopic Myotomy, Endoscopic Mucosal Resection, Colonic Polyps, Abnormal Liver Function, Achalasia, Constipation, Gastrointestinal Cancer.

Dr Jason Dunn

Consultant Gastroenterologist

Specialist expertise: Barrett’s Oesophagus, Bowel Disease, Gastroenterology, Inflammatory Bowel Disease, Crohn's Disease, Ulcerative Colitis, Colonic Polyps, Diarrhoea, Abdominal Pain, Lynch Syndrome, Dyspepsia, Constipation, Acid Reflux, HALO Radiofrequency Ablation, Indigestion, Endoscopic Submucosal Dissection, Eosinophilic Oesophagitis, Colonoscopy, Nutrition, Globus, Trans Nasal Endoscopy.

Dr Jonathan Hoare

Consultant Gastroenterologist

Specialist expertise: Digestive Health, Endoscopy, Colonoscopy, Advanced Polypectomy, Gastroenterology, Capsule Endoscopy, Endoscopic Mucosal Resection, Balloon Enteroscopy, Barrett’s Oesophagus, Barrett’s Ablation, Small Bowel Pathology, Colonic Polyps, Acid Reflux, Irritable Bowel Syndrome, Inflammatory Bowel Disease.

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