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Barrett’s Oesophagus

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 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.

Causes of 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 Barrett’s Oesophagus

Many of the associated symptoms of Barret’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 Barret’s oesophagus include:

  • Difficulty swallowing (dysphagia)
  • Heartburn (burning sensation in the chest)
  • Chest pain
  • Vomiting and nausea
  • Weight loss
  • A feeling of fullness during eating

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 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

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 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 oesophageal cancer, before and after treatment.

IBD Specialists

All our private digestive health specialists at OneWelbeck in London are leaders in their field. They are equipped with the latest medical technology, so they can provide the highest quality treatment at custom-built facilities to ensure you receive the best available care.

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