Why worry about Barrett's oesophagus?

Written by: Dr Aathavan Loganayagam
Edited by: Laura Burgess

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.

By Dr Aathavan Loganayagam

Dr Aathavan Loganayagam trained in medicine at Guy’s, King's and St. Thomas’ medical schools. He then underwent rigorous structured specialty training in gastroenterology and general internal medicine in the well respected South London training programme.

He then spent two years during postgraduate training as a research and endoscopy fellow at Guy’s and St Thomas’ Hospitals, London. His research was in the fields of pharmacogenetics, inflammatory bowel disease and gastrointestinal malignancy. He has received awards and grants for outstanding research work, including the prestigious NHS Innovation London Award.

Dr Loganayagam has numerous publications in peer reviewed journals on all aspects of gastroenterology. He is actively involved in clinical research. He has particular local expertise in the practice of personalised medicine and the utilisation of novel therapeutic agents in the treatment of complex inflammatory bowel disease. He is currently the lead clinician for endoscopy at Queen Elizabeth Hospital, Woolwich.

Diagnostic and advanced therapeutic endoscopy remains a major part of his clinical expertise, including assessment and treatment of inflammatory bowel disease, strictures, polyps and cancers.

Dr Loganayagam is an approachable doctor who takes pride in his communication skills with patients. He is keen to ensure that patients are fully informed and involved in all aspects of their care.

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