Barrett’s oesophagus

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Barrett’s oesophagus

A histologically defined condition affecting roughly 2 million Americans, which develops in patients with GORD/GERD, which is characterised by metaplastic, premalignant intestinal columnar epithelium in the distal oesophagus, and may accompanied by peptic ulceration, typically a sequel of chronic reflux. It carries a 35-40-fold increased risk of oesophageal adenocarcinoma, is accompanied by dysplasia, and has a prognosis similar to that of squamous cell carcinoma (14.5% 5-year survival).
 
Endoscopy
Barrett’s changes include proximal migration of the squamocolumnar Z-line, and patchy areas corresponding to single layered columnar cells in intimate contact with underlying blood vessels.

Management
Low-grade dysplasia: Epithelial radiofrequency ablation.
High-grade dysplasia: Epithelial radiofrequency ablation, oesophagectomy.