What is Barrett’s oesophagus?

The oesophagus (gullet) is the tube that carries food from the mouth to the stomach and is lined by cells similar to those that form the skin (squamous cells). In Barrett’s oesophagus, the lining of the gullet has changed and resembles the lining of the stomach.

What causes Barrett’s oesophagus?

What causes the change in the cells is unclear. It is thought that acid reflux (heartburn) may be linked. As the acid from the stomach moves up the gullet, the cells can become inflamed and painful. This is called oesophagitis. This may heal but if the oesophagus is repeatedly exposed to acid, the cells may change.

This statistically, is more common in men and people who are overweight. It has also been shown that smoking can accelerate changes in Barrett’s oesophagus.

How is it diagnosed?

The condition is often symptomless. People are often found to have Barrett’s oesophagus when they have had an endoscopy (camera test) to look at their stomach. This is usually because of gastro oesophageal reflux (a burning in the gullet, usually following a meal or when bending down). The endoscopist can see the changes in the gullet lining on the screen and take small biopsies (tissue samples). These can be sent for examination under the microscope.

It is important that this condition is regularly monitored to prevent complications. Your consultant will advise you to have regular endoscopies to identify any changes promptly.

Complications

  • Ulcers may develop in the gullet
  • The oesophagus may bleed
  • The gullet may become narrow (stricture) making swallowing difficult
  • Occasionally a cancer may develop in the gullet (this is rare)

Treatment for Barrett’s oesophagus

Tablets aim to reduce the production of acid in the stomach to prevent the reflux.  You will need to take this medication permanently.

The weakened valve at the lower end of the oesophagus which allows reflux to occur may be strengthened by a surgical operation.

There are a few steps you can take to help reduce reflux and in turn, complications:

  • Losing weight
  • Eating small, regular meals
  • Allowing time for foods to be digested before going to bed
  • Avoid tight clothing and bending down after meals

If you have new symptoms of difficulty swallowing, vomiting blood or weight loss, seek urgent medical advice.

Ref: 17-19-110
Review: Jan 21