Barrett's Oesophagus

Question 1

Describe what happens in Barrett’s oesophagus

Answer 1

metaplasia of squamous epithelium to columnar epithelium

Question 2

By how much does the risk of oeseophageal cancer increase when patients develop Barretts/

Answer 2

50-100 fold

Question 3

How is Barrett’s subdivided?

Answer 3

short (<3cm)
long (>3cm)

Question 4

Describe the histology seen in Barretts

Answer 4

columnar epithelium resembling cardiac region of the stomach or that of the small intestine

• with goblet cells, brush border

Question 5

Risk factors for development of Barretts

Answer 5

• GORD = strongest RF
• male gender (7:1 ratio)
• smoking
• central obesity

Question 6

Barretts itself is asymptomatic. TRUE/FALSE?

Answer 6

TRUE

although patients usually are symptomatic of GORD

Question 7

Management of Barretts

Answer 7

• high-dose PPI
• endoscopic surveillance with biopsies (every 3-5 years)
• endoscopic intervention if dysplasia present:
  > radiofrequency ablation
  > endoscopic mucosal resection