Why worry about Barrett's oesophagus?

Barrett’s oesophagus refers to a change to the tissue lining of the oesophagus (or gullet) as a response to reflux of fluid from your stomach. The most common ongoing symptom is heartburn and indigestion. 

About 50% of people with persistent reflux symptoms have Barrett’s change. Overall it is estimated that Barrett’s change occurs in about 10% of the population but can only be diagnosed by a gastroscopy with tissue biopsy.

Here, one of our top gastroenterologists Dr Aathavan Loganayagam explains why it is important to have the condition diagnosed and monitored regularly.
 

Why do we worry about Barrett’s oesophagus?

The reason it is important is that, in certain circumstances where there is associated dysplasia of the tissues, it can lead to oesophageal cancer. If there is no dysplasia on biopsy then the risk of developing cancer is around 0.5% per year, but when high-grade dysplasia is found on biopsy the cancer risk may be up to 5% per year.
 

What can be done about Barrett’s change?

The first treatment is to reduce reflux. Medicines such as omeprazole and other proton pump inhibitors are very effective at this. However, this has not been shown to reduce cancer risk.

If your Barrett’s is of a worrying type, your doctor will recommend regular gastroscopy to look for any indication you might develop cancer. This is called surveillance gastroscopy, but it does not remove Barrett’s tissue.

Effective endoscopic therapy is now available for those patients with Barrett’s oesophagus. This is called radiofrequency ablation (RFA or HALO). Together with endoscopic removal of any irregular areas, RFA has been shown to get rid of over 90% of high-risk Barrett’s change and reduce the cancer risk to around 0.2% per year in the very high-risk groups.


Do not hesitate to book an appointment with Dr Loganayagam if you’re concerned about symptoms of Barrett’s oesophagus.