Barrett's Oesophagus

Barrett's oesophagus was first described in 1957 by Dr. Norman Barrett. It is a condition in which the cells of the lower end of the oesophagus become damaged due to chronic acid exposure caused by acid reflux. An abnormal growth of stomach lining cells replaces the normal oesophagus lining.

The muscle valve at the lower end of the oesophagus (lower oesophageal sphincter) normally remains closed, opening only to allow food and liquid to pass into the stomach. Heartburn occurs when this sphincter opens spontaneously or does not close properly and stomach contents rise into the oesophagus. Acids from the stomach cause the burning sensation known as acid indigestion or gastro-oesophageal reflux (GOR).

Gastro-oesophageal reflux disease (GORD) is a more serious condition resulting from persistent acid reflux over a period of time. If left untreated, complications can occur resulting in the condition known as Barrett's oesophagus and an increased risk of oesophageal cancer. For unknown reasons, Barrett's is found more often in men than women. In the vast majority of cases it is the result of longstanding GORD.

Diagnosis requires the insertion of a small flexible tube with a light source and miniature camera (endoscope) into the oesophagus after the patient is sedated. Small tissue samples are taken and examined microscopically for the presence of stomach lining cells and any evidence of premalignancy.

While there are no medications to reverse Barrett's oesophagus, treating the underlying GORD can slow the progress of the disease and prevent complications. If severely abnormal or cancerous cells are found, surgical removal of the oesophagus is recommended if the patient can tolerate a surgical procedure.

Medical advice should be sought if any of the following warning signs are experienced:

• frequent and longstanding heartburn
• difficulty swallowing
• vomiting blood
• pain under the breastbone where the oesophagus meets the stomach