Barrett’s Oesophagus

Barrett’s Oesophagus is a medical condition that should be routinely monitored by endoscopy.
If left unmanaged, it can develop precancerous changes leading to cancer.

 
Symptoms of Barrett’s Oesophagus are usually no different from reflux which is the main risk factor.
Mr Krishna Epari
Upper gastrointestinal surgeon Perth
 

What is Barrett’s Oesophagus?

To understand Barrett’s Oesophagus, it helps to understand the function of the oesophagus.

The oesophagus is a muscular tube that connects your throat to your stomach. When you swallow food, the sides of the oesophagus squeeze together to form a food bolus which passes through a muscular opening (sphincter) and enters your stomach. At times this sphincter does not close properly. This allows the stomach juices (acid) and sometimes intestinal juices (bile) to splash back into the oesophagus, causing heartburn and/or indigestion. This is called reflux.

In Barrett’s Oesophagus, ongoing irritation by acid and/or bile can lead to changes in the lining of the oesophagus which can become pre-cancerous (dysplasia) and in some cases lead to cancer.

Barret's Oesophagus

People who experience long term heartburn and indigestion are at greatest risk of developing Barrett’s Oesophagus. Increasing age, being male, being overweight and history of smoking also increase the risk.

Barrett's Oesophagus symptoms may include

  • No symptoms at all (silent Barrett’s)
  • Persistent heartburn

Later symptoms or signs of progression may include

  • Difficulty swallowing
  • Painful swallowing
  • Vomiting
  • Weight loss
  • Feeling full when you eat
“Barrett’s Oesophagus is more common when you have symptoms of reflux including heartburn and regurgitation. With Barrett’s Oesophagus, the cells lining the lower oesophagus change in appearance to resemble those of the intestine.”
Mr Krishna Epari
Upper gastrointestinal surgeon Perth

The risks of reflux

“Symptoms of Barrett’s Oesophagus are usually no different from regular heartburn which is a common condition. As a result, many people don’t seek medical treatment until their condition is quite advanced. Most people with cancer of the lower oesophagus have not been previously diagnosed with reflux.”
Mr Alan Thomas
Upper gastrointestinal surgeon Perth

If you have regular heartburn symptoms and are under 40 yrs old then see your GP and have a course of tablet treatment for about 8 weeks. If you continue with heartburn symptoms or symptoms come back then seeing a specialist for an endoscopy is recommended.

If you are over 40 with a new onset of heartburn then seeing a specialist for an endoscopy is recommended.

If you have additional symptoms such as those mentioned above then see your GP for early specialist referral. All our surgeons at Upper GI West are fully qualified and endorsed endoscopists. We are happy and able to provide early, accurate and repeated endoscopies to all our patients.

There is evidence that the rate of cancer caused by Barrett’s Oesophagus is on the increase. Men are at greatest risk, with the prevalence of Barrett’s Oesophagus more common in men.

Remember, although Barrett’s Oesophagus does increase your risk of developing cancer of the oesophagus; the majority of patients with Barrett’s do not develop cancer. They simply need regular endoscopies to check for any suspicious changes in the lining of the oesophagus; then local treatment rather than major surgery is more likely to be sucessfully employed.

Key Points

Repeated reflux for five years or more can put you at risk of Barrett’s Oesophagus
Left untreated, Barrett’s Oesophagus does put you at risk of lower oesophageal cancer
Regular endoscopies with targeted biopsies are important if you have Barrett’s Oesophagus

Barrett’s Oesophagus treatment

Barrett’s Oesophagus treatment is similar to general acid reflux treatment. Proton pump inhibitors (PPIs) can prevent further harm to your oesophagus. In fact, PPIs may even heal damage but will not get rid of Barrett's change in the oesophagus.

A surgical procedure called a fundoplication (where the upper stomach is wrapped around the lower oesophagus) or a hiatal hernia repair can also reduce the reflux and help repair the damage to the oesophagus. PPIs and surgery have an additive effect to minimise exposure of the oesophagus to acid and bile. They may reduce the chance of developing cancer in Barrett’s Oesophagus patients.

If you have been diagnosed with Barrett’s Oesophagus, it’s important to have regular checkup endoscopies with biopsies to look for early signs of cell changes so they can be dealt with before changing into cancer.

“Your doctor will recommend a periodic upper gastrointestinal endoscopy with multiple biopsies based on defined protocols. If there are any progressive or significant cell changes, our experienced team will assess these during endoscopies and organise or perform appropriate treatment for you.”

Assoc Prof Mo Ballal
Upper gastrointestinal surgeon Perth

If cancer is found and surgery is needed, the experienced team at Upper GI West are fully qualified and credentialed to manage your condition. They can carry out an Oesophagectomy (removal of the oesophagus) using minimally invasive "keyhole" surgery if required.

Because an Oesophagectomy is advanced major surgery, you may need to spend a week or two in hospital. Our team of surgeons has extensive experience with these operations, helping ensure you are in safe hands.

“An oesophagectomy is where we remove affected sections of your oesophagus. We then rebuild your oesophagus with either part of your stomach or, if needed, your large intestine.”
Mr Matt Henderson
Upper gastrointestinal surgeon Perth
barrett's oesophagus

A team of experienced surgeons

Our expert surgeons offer surgery for the full range of Upper Gastrointestinal conditions. We ensure the highest quality service from diagnosis and assessment, through to surgery and management of your condition.

We are a team of Perth's most experienced Upper Gastrointestinal surgeons. But our care goes well beyond surgery. We look at your health and your life, not just at the procedure. We talk about your personal needs, your lifestyle and ways to make your journey as comfortable as possible.

Speak to our friendly team about specific requirements or concerns you may have. We will do everything we can to support you and help you prepare for your treatment.