Barrett's Oesophagitis

Barrett’s is a condition that arises when various cells belonging to the stomach settle in the oesophagus (the gullet); it calls for follow-up and is diagnosed by examination by the pathologist. It generally appears in patients with chronic reflux disease — that is, reflux of long standing.

In two to five of every hundred patients with Barrett’s, dysplasia is found on examination by the pathologist. The diagnosis of dysplasia in these patients has to be assessed by a second pathologist. If the same diagnosis comes back, the patient is advised on a strict diet and on drugs, and a second endoscopic examination within three to six months.

If the dysplasia is still there, the areas of dysplastic cells are identified by staining at chromoendoscopy, and whichever suits the patient of mucosectomy, laser ablation or surgical treatment is recommended.

In patients diagnosed with Barrett’s who have no dysplasia, what is recommended is diet, treatment, changing the habits that cause reflux (not eating too much, losing weight, raising the bed by a pillow, not eating at night and so on), drugs, and regular endoscopic follow-up.

How often should people with Barrett’s oesophagus be checked?

Barrett’s oesophagus is a change in the structure of the cells in the lower part of the gullet. It is usually linked to long-standing reflux.

Barrett’s oesophagus is not cancer. In some patients, however, precancerous changes can develop over time. For this reason, suitable patients have regular gastroscopy checks.

If the biopsies show no precancerous cell change (dysplasia):

• Barrett’s shorter than 3 cm: usually a gastroscopy every 5 years.
• Barrett’s 3 cm or longer: usually a gastroscopy every 3 years.

If dysplasia is found on biopsy, closer assessment or endoscopic treatment may be needed.

Remember: not every patient with Barrett’s needs a gastroscopy every year. The interval depends on the length of the Barrett’s segment and the biopsy result.

Seeing a gastroenterologist with your gastroscopy and pathology reports allows a follow-up plan that suits you to be set.