Barrett’s Oesophagus is a condition in which the cells lining the lower part of the oesophagus change to resemble the cells of the intestine. This is often due to prolonged exposure to stomach acid that refluxes (backs up) into the oesophagus. Normally, the oesophagus is lined with squamous cells, but over time, they can be replaced with columnar cells, which are more resistant to acid.
Why Does Barrett’s Oesophagus Happen?
Barrett’s Oesophagus is primarily caused by chronic gastro-oesophageal reflux disease (GERD), which occurs when stomach acid frequently flows back into the oesophagus:
- Chronic exposure to stomach acid: Long-term GERD can cause the oesophagus lining to undergo a process known as metaplasia, where the normal cells change in response to damage from acid reflux.
- Risk factors: Other factors that may contribute include obesity, smoking, a diet high in fatty or fried foods, and family history of Barrett’s Oesophagus.
When Does Barrett’s Oesophagus Occur?
Barrett’s Oesophagus usually occurs in individuals who have long-term GERD:
- Symptoms of GERD such as heartburn, regurgitation, and difficulty swallowing can precede the development of Barrett’s Oesophagus.
- It is more common in adults aged over 50 and in men than women.
- Long-term and frequent acid reflux is a significant risk factor.
How to Treat Barrett’s Oesophagus
Treatment focuses on managing symptoms, reducing the risk of progression to oesophageal cancer, and monitoring the condition:
- Lifestyle changes:
- Dietary changes: Avoid foods that can trigger reflux (e.g., fatty foods, chocolate, caffeine, citrus, tomatoes).
- Maintain a healthy weight: Reducing excess weight can decrease abdominal pressure and lessen acid reflux.
- Quit smoking: Smoking can exacerbate acid reflux symptoms and increase the risk of oesophageal cancer.
- Elevate the head of the bed: This can help reduce nighttime acid reflux.
- Medications:
- Proton pump inhibitors (PPIs) or H2-receptor antagonists** are often prescribed to reduce stomach acid production and relieve symptoms.
- Antacids may be used for short-term relief of mild symptoms.
- Regular monitoring:
- Endoscopy: A procedure where a thin tube with a camera is inserted down the throat to examine the oesophagus. Regular endoscopic checks can detect any changes in the oesophagus lining, such as dysplasia (abnormal cell growth) that may lead to cancer.
- Biopsies: Small tissue samples may be taken during an endoscopy to check for precancerous changes.
- Surgical treatment:
- In severe cases, endoscopic mucosal resection (removing abnormal cells) or radiofrequency ablation (burning off abnormal cells) may be used to destroy affected tissue.
- Surgical removal of the damaged part of the oesophagus (oesophagectomy) may be considered in cases of high-grade dysplasia or early oesophageal cancer.
- Follow-up care:
- Regular follow-up with a healthcare provider is important to monitor for changes in the condition and adjust treatment as needed.
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