Barret's oesophagus

Question 1

What is the pathophysiology of barett’s oesophagus?

Answer 1

Metaplasia where squamous epithelium is replaced by columnar epithelium, this can include goblet cells and brush border

Question 2

What are the classifications of Barett’s oedophagus?

Answer 2

Short = <3cm.
Long = > 3cm

Question 3

What are the risk factors for Barrett’s oesophagus?

Answer 3

GORD,
Male gender,
Smoking,
Central obesity
Alcohol is not associated with barret’s but is associated with gord and oesophageal cancer

Question 4

What are the symptoms of Barrett’s oesophagus?

Answer 4

Barrett’s itself is asymptomatic but it will often have coexistent GORD symptoms

Question 5

What is the management of Barrett’s oesophagus?

Answer 5

High dose PPI - reduced progression to dysplasia.
Endoscopy surveillance with biopsies every 3-5 years.
If dysplasia is identified then endoscopic intervention is offered: radiofrequency ablation (first line), endoscopic mucosal resection.

Question 6

What are the complications of Barrett’s oesophagus?

Answer 6

Oesophageal adenocarcinoma