What is Barrett’s Oesophagus?

Barrett’s oesophagus is a condition where the lining along the oesophagus (food pipe) becomes damaged from prolonged exposure to stomach acid. Usually, the role of the oesophagus is to carry food and liquid from the mouth to the stomach. According to research from The Medical Journal of Australia, around 4% of Australians live with Barrett’s oesophagus [1]. Recently, there has been an increase in the number of people with this condition. However, this could be due to the more accessible testing worldwide. Ethnicity and gender have a role in determining who is more likely to develop Barrett’s oesophagus. Over several decades, the rate of oesophageal adenocarcinoma (a type of cancer in the throat) has increased significantly. If left untreated, those with Barrett’s oesophagus have a higher risk of developing adenocarcinoma than those who do it. Seeking medical attention is essential for reducing this risk and receiving appropriate treatment.
 

Barrett’s Oesophagus Symptoms

Those with gastro-oesophageal reflux disease (GORD) can develop Barrett’s oesophagus. As a result, there may be similar symptoms of GORD. Symptoms of Barrett’s oesophagus include:

• Constant heartburn
• Difficulty with swallowing
• Pain with swallowing
• Vomiting
• Loss of appetite

 

What Causes Barrett’s Oesophagus?

Barrett’s oesophagus occurs when the lining in the oesophagus (food pipe) changes to a similar texture to the intestines. One of the most common causes of Barrett’s oesophagus is gastro-oesophageal reflux disease (GORD) or acid reflux. Constant exposure to acidic environments can irritate the oesophagus, which can cause inflammation and thickening of the lining.

Barrett’s Oesophagus Risk Factors

One of Barrett's oesophagus's most significant risk factors is having GORD or acid reflux. Other risk factors include [2]:

• Age
• Being male
• Obesity (especially if there’s increased fat along the abdominal and torso region)
• Smoking
• Living with hiatal hernia

 

Barrett’s Oesophagus Diagnosis and Tests

If you are at high risk and exhibit symptoms of Barrett’s oesophagus, your doctor may recommend further testing. Early detection of this condition is essential to prevent further complications. There are two main ways to detect Barrett’s oesophagus: endoscopy and biopsy. Your doctor may recommend other investigations and tests to rule out other possible conditions. Regular testing may be required for those with a higher risk of developing this condition.

Endoscopy

An endoscopy is a procedure that helps look for any abnormal signs and changes along the oesophagus. Doctors will recommend and/or perform an endoscopy through the mouth using an endoscope. This is a long, thin instrument with a camera attachment to capture images inside the body. Instead of the standard pale pink colour, those with Barrett’s oesophagus will have patches of salmon-red areas [2].

Biopsy

A biopsy involves taking a tissue sample along the oesophagus for further analysis. Those with Barrett’s oesophagus will have a more similar appearance to the intestines than what is usually found [2].
 

Barrett’s Oesophagus Treatment

The management of Barrett’s oesophagus will depend on the findings from the test and the severity of the condition. Those with inconclusive results may need additional testing to determine whether treatment is required. While those in more severe stages of this condition need immediate treatment to help reduce the risk of cancer. Your doctor may refer you to other health services and medical specialist(s) (e.g. gastroenterologist) for treatment.

Dietary Changes

While there is no specific diet for Barrett’s oesophagus, it is recommended to eat foods that are less likely to trigger acid reflux (which is one of the main causes). Your doctor may refer you to a dietitian or nutritionist to provide additional support. Examples of foods to avoid that may cause acid reflux include:

• Fatty and oily foods (e.g. fries, butter, ice cream, etc.)
• Spicy foods
• Acidic and citrus fruits (e.g. lemon, orange, pineapple, etc.)
• Alcohol
• Coffee

Medications

Your doctor may prescribe you medications to help control acid reflux. The medicines aim to prevent further damage to the oesophagus from reflux.

Endoscopic Resection

Parts of the damaged oesophagus will be removed under the guidance of the real-life images captured during an endoscopy. The removed tissue can help with disease detection and help prevent it from developing into cancer [3].

Radiofrequency Ablation

Radiofrequency ablation could be an option for those with tissue that is determined to have a high risk of developing cancer. Doctors will perform this procedure using electrical energy and heat to remove damaged tissue [3].

Surgery

Depending on the severity of the condition, you may require surgery to remove the damaged areas. Your doctor will refer you to a medical specialist (e.g. gastroenterologist, etc.) who will determine what type of surgery may be necessary.
 

Recovery and Complications

If left untreated, there is a risk that those with Barrett’s oesophagus will develop oesophageal carcinoma. This dangerous condition can lead to poor health outcomes and even early death. Fortunately, receiving appropriate treatment is 90% effective for reducing the risk of developing cancer [4].
 
 

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