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About

Barrett's oesophagus is a condition which affects the lower gullet (oesophagus). In this condition, the cells that line the affected area of the oesophagus change shape and behaviour. This change in cells can be seen at endoscopy (see figures 1 and 2 below).

The cells of Barrett's oesophagus are not cancerous. However, compared to a population with normal gullets, patients with Barrett's oesophagus have a higher risk of developing cancer of the oesophagus. Accurate measurement of the level of increased risk is difficult. In the UK, it is estimated that the risk of developing oesophageal cancer in patients with Barrett's is approximately 1 in 100 per year (Almond, Barr and Jankowski, 2014). This is why patients diagnosed with Barrett's oesophagus are advised to have regular (surveillance) endoscopies to detect any abnormalities in the cells of the oesophagus, by taking regular biopsies from the Barrett's.

If 'normal' Barrett's cells develop further abnormal changes, such as dysplasia, then a different set of advice and treatment is advised, which can be found here.

Barrett's without annotation

Figure 1. Appearance of Barrett's oesophagus at endoscopy. Source: UHBW NHS Foundation Trust.

Barrett's with annotation

Figure 2. Annotated picture of Barrett's oesophagus at endoscopy. Source: UHBW NHS Foundation Trust.

Symptoms

Barrett's oesophagus does not cause symptoms. One of the main factors causing Barrett's oesophagus to occur is the reflux of acid from the stomach into the oesophagus. In some people, acid reflux does not cause significant symptoms. In some people, however, reflux can cause a burning sensation in the lower chest or upper abdomen, difficulty swallowing, or the regurgitation of acid or food into the throat. These symptoms are common in people with Barrett's oesophagus. However, they are caused by the acid going back up into the oesophagus, rather than the change in cells in the oesophagus.

References

Max Almond, Hugh Barr and Janusz Jankowski, 'Barrett's oesophagus', chapter in 'Oesophagogastric Surgery: a companion to specialist surgical practice.' Edited by S Michael Griffin, Simon A Raimes, Jon Shenfine. 2014.