Barret's Oesophagus

Barrett's oesophagus is a pre-malignant condition where there’s a change of oesophageal epithelium from squamous to columnar. It's a risk factor for Oesophageal adenocarcinoma.

Risk factors - GORD, Family hx, Obesity

Metaplasia-Dysplasia-Carcinoma Sequence:

This occurs in a small minority of patients with Barrett’s as the metaplastic, columnar epithelium can progress to a dysplasia, and then an adenocarcinoma

N.B. Progression of Barrett’s into an Adenocarcinoma is NOT INEVITABLE.

Regular screening and biopsies are needed to check for dysplasia.

Management:

• PPI

• Ablation - this allows for normal, healthy cells to form (only for those with some degree of dysplasia)