Barrett's oesophagus is a change in the oesophagus caused by frequent acid and bile reflux over a long time. It is of interest because it can increase the risk of cancer of the oesophagus. In people at higher risk, that risk might be reduced by scheduled gastroscope examinations, and cutting out of pre-cancerous tissue by an expert endoscopist.
Barrett’s oesophagus (BO) is abnormal tissue at the bottom of the oesophagus caused by chronic reflux of bile and acid from the stomach. Instead of the usual 'squamous' cells of the oesophagus, the cells in BO look like those found in the intestine (‘intestinal metaplasia’). The significance of BO is that in some people this can be a risk factor for oesophageal cancer.
Oesophageal cancer appears to occur most frequently in older Caucasian males. Other risks include smoking, obesity, and a family history of this cancer. If BO is found at your gastroscopy and you have any of these risk factors then your gastroenterologist may recommend surveillance – repeat gastroscopies every few years to look for a change in the BO called dysplasia.
It is recommended that if you undergo surveillance of BO, that even if you tolerate gastroscopies well, you make arrangements to allow sedation to be given for your procedure. Properly-performed surveillance takes time, and it is usually easier for your Gastroenterologist to see abnormal changes in patients who are sedated.
Dysplasia represents the early stages of a path to cancer. If dysplasia is ever found in BO then the surveillance procedures will become more frequent, maybe even three or six-monthly. It is critical that at this point an expert in BO is involved, as reliable detection of precancerous lesions requires particular skills and management may involve resection of the BO during the gastroscopy which is only performed by a few operators in NZ.
See more about BO and its treatment in Health Matters.