An expert guide to Barrett’s oesophagus

Barrett’s oesophagus is a condition affecting the oesophagus’s lining which can leave patients with acid reflux-like symptoms. In this informative article, highly esteemed consultant gastroenterologist Professor Pradeep Bhandari gives expert insight on many aspects of the condition, including its relation to symptoms of reflux and how patients are monitored in the long term.

What is Barrett’s oesophagus?

Barrett's oesophagus is basically an abnormal lining at the bottom end of your oesophagus. We believe that the condition develops because of acid and bile reflux. The inner lining of the oesophagus is the food pipe which connects your mouth to your stomach. When people have a long term reflux, the bottom end of the oesophagus’s inner lining changes and it begins to look like the lining of your stomach.

The condition in itself doesn't have any symptoms and can only be diagnosed by having an endoscopy. Although it is asymptomatic, it is commonly associated with reflux which can give provoke symptoms such as heartburn and food or acid coming up to your mouth.

Is Barrett’s oesophagus hereditary?

Barrett's oesophagus is common in the western world, but it is not hereditary. Sometimes we see more than one patient in the same family but that doesn't mean that there is a higher transmission of the disease. There are also genes linked to Barrett's oesophagus but the true answer is that there is no hereditary transmission of the condition. It's more related to environment, lifestyle and our own genetic background.

Can diet help with Barrett’s oesophagus?

Questions related to diet and various health conditions are very common as people often like to know what they can do to avoid or treat their condition and that's a very good way of thinking about it. Specifically for Barrett's oesophagus, there is no direct interaction with diet. However, as I said, this is a condition which is caused or worsened by reflux and reflux is affected by various types of diet. Therefore, indirectly, there is a connection between Barrett's and diet.

Patients with Barrett’s oesophagus therefore need to know those food and dietary habits which make reflux worse and so they can avoid them. Some common examples of things that make reflux worse are:

• fatty food
• spicy food
• fizzy drinks
• too much alcohol
• tea
• coffee

Going to bed within a couple of hours of having a big meal can also worsen reflux as lying down flat acid to reflux back into your oesophagus. Therefore, eating early in the evening or leaving at least two to three hours between having a meal and lying down can help. The other important thing to note would be instead of frequent snacking, people should try to adopt a habit of having just three proper meals to reduce reflux.

Can Barrett’s oesophagus cause back pain?

Barrett’s oesophagus can cause frequent burping and in some patients, because of reflux and acid coming into your oesophagus, the oesophagus becomes very sensitive and it can go into spasm. When this occurs, it can lead to chest pain or in some rare cases, back pain. It’s important to remember that these symptoms are not directly related to Barrett's oesophagus, but to acid reflux.

Can Barrett’s oesophagus cause cancer?

Barrett's oesophagus is considered as a pre-malignant condition, by which we mean that in a very small proportion of patients, it can lead to the development of cancer. For that reasons, patients with Barrett's oesophagus undergo an endoscopy every two to three years to monitor their condition, take biopsies and make evaluations to ensure that no nasty changes are occurring. It’s important to note that this risk is very small; between 0.5 and 1 per cent of Barrett’s oesophagus patients per year will develop cancer.

Although it is a small risk, it is taken seriously by practitioners as we do not know which patients will have their condition progress to cancer and for this reason patients are monitored on a regular basis.

If you are seeking treatment for Barrett’s oesophagus, you can book a consultation with Professor Bhandari by visiting his Top Doctors profile.