Barrett's Oesophagus Flashcards
what is Barretts oesophagus
where prolonged exposure of the squamous epithelium of mucosa to refluxate causes metaplasia from squamous to columnar epithelium due to mucosal inflammation and erosion
what is the cell change to and from
squamous epithelium to columnar epithelium
what causes Barrett’s Oesophagus
main cause is GORD (gastrooesophageal reflux disease)
what causes GORD
wearing/ dysfunction of the lower oesophageal sphincter
risk factors
GORD, old age, male sex, white ethnicity, family Hx, smoking and obesity
what increases risk of GORD
hiatus hernias
epidemiology summary
1/10 people experience heartburn daily, 3-5% of those with GORD will develop Barretts oesophagus
how does Barretts oesophagus present
heartburn, dysphagia, burning pain when swallowing, nausea, water-brash (sour taste in mouth), bloating and belching
what investigations will be done to confirm Barretts oesophagus
upper GI endoscopy, OGD and a biopsy
what do you expect to see in a biopsy of someone with Barretts
cells appear columnar, not squamous
management of pre-malignant/ high grade dysplasia
oesophageal resection or eradicative mucosectomy
management of low grade dysplasia
annual endoscopic surveillance recommended
management of no dysplasia/pre-malignant changes
surveillance endoscopy every 1-3 years and anti-reflux measures such as high dose PPI (e.g. lansoprazole or omeprazole)
examples of PPI
omeprazole and lansoprazole
possible complications of Barretts
development into oesophageal adenocarcinoma or a risk of dysplasia
