Surveillance
Further information:
Patients with Barrett’s Oesophagus may be
advised to have regular endoscopy
examination and biopsy. This is done in
order to assess further changes in the lining
that may cause complications.
Sue Osborne, Upper GI Specialist Nurse
01935 384877
Yeovil District Hospital.
It is important to contact your doctor if you
develop symptoms such as:
•
Difficulty in swallowing
•
Vomiting blood
•
Weight loss
The Digestive Disorders Foundation
Provides information leaflets on digestive
disorders.
P.O. Box 251, Edgware, Middlesex, HA8
6HG (please enclose a stamped
addressed envelope).
www.digestivedisorders.org.uk
Barrett’s
Oesophagus
If you require this leaflet in
any other format, eg,
large print, please telephone
01935 384590
Leaflet No 4801007
06/07
Gastroenterology
What is Barrett’s Oesophagus?
The oesophagus (gullet) is the muscular
tube that carries food from the mouth to
the stomach. The inner lining of the
oesophagus is made of cells similar to
those that form the skin (squamous cells).
Barrett’s Oesophagus is a condition in
which the cells in the lining of the lower
end of the oesophagus change from being
‘skin-like’ to being like the lining of the
stomach.
What causes Barrett’s Oesophagus?
Evidence suggests that Barrett’s
Oesophagus is caused by oesophageal
reflux. In most people this is caused by the
gastric juices flowing the wrong way,
through the lower oesophageal sphincter
and up into the oesophagus. Muscle
contraction normally keeps this sphincter
closed but reflux occurs when this muscle
is weak. The oesophagus does not have
the same protective lining as the stomach
and when gastric juices get into the
oesophagus, the acid causes a sharp
burning sensation in the chest, sometimes
moving up into the throat and is
commonly
known as ‘heartburn’. Reflux can be
brought on by bending or physical
exercise, particularly after a meal, and is
usually worse at night. The reason why the
muscle becomes weak is not fully
understood. In some cases, reflux is
caused by a hiatus hernia. This is where
part of the stomach is pushed though the
lower oesophageal sphincter.
Certain factors can make people more
likely to suffer from reflux oesophagitis.
These include smoking, drinking too much
alcohol and being overweight. Sometimes
fatty, acidic or spicy foods cause reflux.
If reflux happens often enough, the
oesophagus becomes damaged and causes
oesophagitis (inflammation of the
oesophagus). This can lead to changes in
the cells known as Barrett’s Oesophagus.
Barrett’s Oesohagus appears to be more
common im men and in people who are
overweight. Smoking has also been shown
to accelerate changes to Barrett’s
Oesophagus.
What are the symptoms of Barrett’s
Oesophagus?
Some people have no symptoms at all.
However, the most common symptoms
are heartburn and indigestion.
Barrett’s Oesophagus can lead to
complications such as ulcers, narrowing of
the oesophagus causing difficulty in
swallowing and occasionally, cancer. The
vast majority of patients who have
Barrett’s Oesophagus do not develop any
complications.
Diagnosing Barrett’s Oesophagus
Barretts Oesophagus can be diagnosed by
means of an endoscopy. A thin flexible
tube is passed through the mouth, into the
oesophagus and into the stomach.
Samples of the lining (biopsies) can be
taken to confirm the diagnosis and
highlight any complications that may be
developing.
What treatments are available?
•
Medication can be prescribed to
suppress the acid production in the
stomach and therefore reduce the
quantity of acid available to reflux into
the oesophagus.
•
National studies are being carried out
to identify how best to treat Barrett’s
Oesophagus. Treatments may include
surgery to prevent reflux or laser
therapy.
The following may help to reduce reflux:
•
Losing weight if necessary
•
Eating smaller meals at regular
intervals
•
Avoiding eating meals just before
going to bed
•
Avoiding tight clothing
•
Avoiding bending down or
stooping particuarly after meals
•
Stopping smoking
•
Raising head of bed