Barrett's Oesophagus (Barrett's Esophagus)

Page 1 2 3

What is Barrett's Oesophagus?

Barrett's oesophagus is a complication of gastro-oesophageal reflux disease (GORD). Barrett's oesophagus develops when the cells of the lower oesophagus are damaged through continuous exposure to stomach acid and undergo a change ('metaplasia') to a different cell type. This places the individual at increased risk of developing oesophageal cancer. The image below shows an endoscopic view of an ulcerated oesophagus. This is part of the disease process leading to barrett's oesophagus.

Inflamed oesophagus due to Gastroesophageal reflux disease

Who gets Barrett's Oesophagus?

Barrett's oesophagus is divided into short-segment (<3cm) and long-segment (>3cm) disease, according to the length of oesophagus that is affected. Short-segment disease is thought to be present in as many as 15% of the population, while long-segment disease probably only affects about 0.5%.

Barrett's oesophagus affects men about twice as often as women. The risk of developing disease increases with age, with an average age at diagnosis of 60 years. Middle-aged men are the most commonly affected group. In general, the longer the duration of GORD, the greater the risk of developing Barrett's oesophagus.

Predisposing Factors

The major predisposing factor for development of Barrett's oesophagus is a history of chronic gastroesophageal reflux disease. Smoking and excessive alcohol consumption may also increase your risk.
A family history of either gastroesophageal reflux disease or Barrett's oesophagus may predispose someone to development of the disease.

Some studies have suggested that people with coeliac disease or systemic scleroderma may be at increased risk of developing Barrett's oesophagus. However the exact risks of these conditions is not known.

Progression

The major risk of Barrett's oesophagus is that the condition may progress to cancer of the oesophagus. This occurs at a rate of 0.5% per year; meaning that if 200 patients are identified as having Barrett's oesophagus, one patient in that group would be expected to develop oesophageal adenocarcinoma each year.

Other complications of Barrett's oesophagus include ulceration of the oesophagus and development of strictures. This can lead to difficulties with swallowing.

Once the metaplasia (cell change) of Barrett's oesophagus has occurred, it is virtually impossible to reverse the process. Treatment with antacid medications or surgery generally does not lead to regression. This means that regular surveillance of patients with significant (>3cm) metaplastic change is important to ensure that any pre-cancerous changes are detected early.

Page 1 2 3