What is Barretts oesophagus?
Barrett's oesophagus, which is named after the doctor who first described it, is a condition which affects the lower oesophagus.
In Barrett's oesophagus the cells that line the affected area of the gullet (oesophagus) become changed.
The changed cells of Barrett's oesophagus are not cancerous but they do have an increased risk of turning cancerous, in time. The chance, however, that the changed cells will become cancerous is small and studies have shown that for a person diagnosed with Barrett's oesophagus, their lifetime risk of developing cancer of the oesophagus is about 1 in 20 for men and about 1 in 33 for women.
WHAT CAUSES BARRETT'S OESOPHAGUS?
The cause in most cases is thought to be due to long-term reflux of acid into the gullet (oesophagus) from the stomach. The acid irritates the lining of the lower oesophagus and causes inflammation which is known as oesophagitis. With persistent reflux, the cells lining the gullet eventually change. It is thought that about 1 in 20 people who have recurring acid reflux will proceed to develop Barrett's oesophagus. The risk is mainly in people who have severe acid reflux for many years. Barrett's oesophagus seems to be more common in men than in women and typically affects people between the ages of 50 and 70 years. Other risk factors for Barrett's oesophagus that have been suggested include smoking and being overweight (particularly if you carry excess weight around your middle).
SYMPTOMS OF ACID REFLUX AND OESOPHAGITIS
Heartburn is the main symptom of acid reflux and oesophagitis and it is described as a burning feeling that arises from the upper tummy or lower chest towards the neck. Other symptoms include:
l Feeling sick (nauseated)
l An acid taste in the mouth
l A burning pain when you swallow hot drinks
WHAT CAUSES ACID REFLUX AND WHO GETS IT?
The circular band of muscle at the bottom of the gullet normally prevents acid refluxing from the stomach into the gullet. Problems occur, however, if this band of muscle weakens and does not work very well or if due to a weakening in your lower chest muscle (diaphragm), the stomach protrudes up into the lower chest forming what is known as a hiatus hernia.
Barrett's oesophagus itself usually causes no symptoms. However you are likely to have, or have had, the symptoms of long-standing or severe acid reflux as described above.
You may have a gastroscopy if you have severe or persistent symptoms of acid reflux and for this test a thin tube is passed down the gullet into the stomach, enabling the doctor to look inside. This test can usually help to diagnose Barrett's oesophagus. If Barrett's oesophagus is suspected during this test, several small samples or biopsies are taken from the lining of the gullet and these are then examined under a microscope, in the laboratory. where a pathologist subsequently makes the official diagnosis.
When you have been diagnosed with Barrett's oesophagus, you may be advised to have repeat gastroscopies where biopsies of the lining of the gullet can be taken at regular intervals in order to monitor the condition. The exact timeframe between gastroscopies and biopsies varies from person to person, depending on the degree of change of the cells lining the gullet, and can be anything between every 2-3 years and every 3-6 months.
AN IMPORTANT NOTE
If you have Barrett's oesophagus and you develop any new symptoms such as weight loss, vomiting blood or difficulty swallowing, it is important that you see your doctor urgently.
Further help and information is available from the www.barrettscampaign.uk and FORT (Fight Oesophageal Reflux Together- www.fortcharity.org.uk)