A muscular and hollow tube or channel that connects the mouth to the rest of the digestive system, the oesophagus plays an important role when it comes to enjoying optimal gastroenterological health. Barrett’s oesophagus refers to a condition that occurs when the cells lining the lower oesophagus change and resemble cells located in the stomach and intestine, due to constant exposure to stomach acid.
The latter occurs due to a weakened sphincter, which allows the acidic content of the stomach to enter the oesophagus. If this takes place over the course of a few years, cell changes in the oesophagus occur.
As outlined above, Barrett’s oesophagus can be caused by long-term gastroesophageal reflux. However, both conditions do not enjoy a clear-cut relationship; it is possible to experience either condition without experiencing the other. That being said, Gastroesophageal Reflux Disease (GORD), as it is officially known in the medical community, is one of the biggest risk factors for this condition.
It is estimated that up to 10% of people diagnosed with chronic reflux go on to develop Barrett’s oesophagus.
Other risk factors for this condition include race and gender (white males with GORD are highly susceptible to the symptoms of this condition), age, and long-term smoking or even a prior history of it.
Barrett’s oesophagus does not cause symptoms unless complications such as oesophageal cancer has developed within it. The early symptoms are very similar to those of heartburn and, therefore, many mistakenly believe that they’re experiencing the latter. In many cases, this mistaken belief prevents people from receiving the treatment they require, increasing their risk of complications of Barrett’s oesophagus. Symptoms include difficulty or painful swallowing, constant heartburn, feeling full during meals, and vomiting.
One of the most serious complications of this condition includes the onset of oesophageal cancer, which is diagnosed in about 200 people with Barrett’s oesophagus, every year. While this will not take place in every case, managing your symptoms and receiving prompt and effective treatment is crucial in preventing symptoms of cancer from emerging.
If you’re experiencing symptoms, drugs to reduce or eliminate acid reflux will be included in your course of treatment. Medication such as lansoprazole, rabeprazole, pantoprazole, and omeprazole are among those most commonly prescribed.
Endoscopic procedures: Gastroscopy
If your doctor suspects that you may have developed dysplasia, which is a precancerous group of cells or a carcinoma, he may conduct an endoscopy with an ultrasound probe to see to what extent the abnormal tissue has been formed or spread.
In the event that either dysplasia or a carcinoma can be detected, your doctor will try to remove these through a minor procedure conducted during the endoscopy, itself.
Ablation therapy is where an electrode is passed through the endoscope to deliver heat to the area affected by Barrett’s oesophagus. This tissue then falls off and is replaced by healthy cells.
Also known as radio-frequency ablation (RFA) or HALO-RFA, this type of treatment usually follows the endoscopic removal of dysplasia or carcinoma, as the remaining affected area of the oesophagus carries a high risk of cancer.
This type of surgery for Barrett’s oesophagus is reserved only for certain cases, especially if you tend to reflux large volumes of fluid.
Anti-reflux surgery, however, may not be a permanent solution and your symptoms may re-emerge. Further, in the event that cancerous cells are detected, the lower half of your oesophagus will also need to be removed.
While Barrett’s oesophagus can be treated without too much difficulty, especially if it’s diagnosed early, neglecting to manage your symptoms can lead to serious consequences, including oesophageal cancer.
With personalised treatment and medical guidance, you may be able to reduce any pain and discomfort you may be experiencing as a result of this condition. For more information, speak to Dr Suhirdan Vivekanandarajah, an interventional gastroenterologist and hepatologist, in Sydney.
Got a referral from your doctor?
Please click below to request an appointment