Barrett’s Oesophagus
What is Barrett’s Oesophagus?
Barrett’s Oesophagus, often known just as Barrett’s, is a condition that affect some people who have had severe reflux of acid and bile (heartburn) for a long time. The acid and bile from the stomach can cause inflammation to the cells lining the oesophagus. If this happens over many years, these cells may start to change, becoming more like the cells that line the intestine. The changed cells of Barrett’s Oesophagus are not cancerous. However, these cells have an increased risk (compared with normal oesophagus cells) of turning cancerous in time. The changed cells in Barrett’s Oesophagus can develop something called dysplasia. A cell with dysplasia is an abnormal cell. It is not cancerous, but is more likely to develop into cancer than other cells. There are various degrees of dysplasia from low-grade to high-grade (severe) dysplasia. Cells that are classed as high-grade have a high risk of turning cancerous at some point in the future. But note: the chance that it will progress to dysplasia, then to high grade dysplasia and then to cancer is small. In the majority of cases, the changes in the cells remains constant and do not progress.
What is the treatment for Barrett’s Oesophagus?
Most treatments for Barrett’s Oesophagus aim to reduce the acid and bile reflux and control symptoms. The most common are tablets called Proton Pump Inhibitors, these help to reduce the acid produced in the stomach; these tablets will probably need to be taken permenantly.
What you can do
- If your heartburn is worse at night, avoid eating large meals in the evening. Raise the head of your bed so that your head is higher than your stomach
- Reduce or cut out alcohol and caffeine
- Avoid foods that you know trigger your heartburn
- If you are overweight, try to lose weight
- If you are a smoker, quit
Surgical treatment
You may have surgery recommended to strengthen the weak valve at the lower end of your oesophagus. This surgery is called a Fundoplication and can be done as a keyhole (laparoscopic) procedure. However, as with all operations, there are benefits and risks and this treatment is not recommended for everyone. It is important to discuss the options with your doctor.
Regular check-ups
If you have been diagnosed with Barrett’s oesophagus regular check-ups will be recommended to have both an endoscopy and biopsy. How often you have these check-ups will depend; maybe once or twice a year or every two years, your doctor will advise you. These regular check-ups will allow your doctor to monitor any changes in the cells of your Oesophagus and to alter your treatment as necessary.