Is Barrett’s oesophagus curable?

Barrett’s oesophagus is a condition in which the lining of the oesophagus changes, often as a result of prolonged acid reflux or gastro-oesophageal reflux disease (GORD). While it is not considered curable in the traditional sense, it can be effectively managed, and in some cases, treatments may reverse the abnormal tissue changes or significantly reduce associated risks.

What causes Barrett’s oesophagus?

Barrett’s oesophagus develops when chronic exposure to stomach acid causes damage to the oesophageal lining. Over time, the normal squamous cells are replaced by columnar cells, a process called intestinal metaplasia. Factors that increase the risk of Barrett’s oesophagus include:

• Long-standing acid reflux or GORD.
• Obesity, particularly abdominal obesity.
• Smoking and alcohol consumption.
• A family history of Barrett’s oesophagus or oesophageal cancer.

Is it curable?

While the abnormal tissue changes in Barrett’s oesophagus may not always be reversed, treatment aims to control symptoms, prevent further damage, and reduce the risk of progression to oesophageal cancer.

What are the treatment options for Barrett’s oesophagus?

Management strategies depend on the severity of the condition and whether precancerous or cancerous changes are present:

• Lifestyle modifications:
  • Losing weight and maintaining a healthy BMI.
  • Avoiding foods and drinks that trigger acid reflux, such as spicy foods, caffeine and alcohol.
  • Elevating the head of the bed to reduce reflux during sleep.

• Medications:
  • Proton pump inhibitors (PPIs) are commonly prescribed to reduce stomach acid production, easing symptoms and protecting the oesophagus from further damage.
  • Antacids and H2 receptor blockers may also be used for additional symptom control.

• Endoscopic therapies:
  • Radiofrequency ablation (RFA): This minimally invasive procedure uses heat energy to destroy abnormal cells in the oesophageal lining, allowing healthy tissue to regenerate.
  • Endoscopic mucosal resection (EMR): Abnormal tissue is removed using an endoscope, particularly in cases where precancerous changes or small tumours are present.

• Surgical options:
  • For severe cases or when endoscopic therapies are insufficient, surgery such as an oesophagectomy may be recommended. This involves removing the affected part of the oesophagus and reconnecting the remaining portion to the stomach.

Monitoring and long-term outlook

Regular monitoring with endoscopy is essential for patients with Barrett’s oesophagus. This allows doctors to detect any progression to dysplasia (precancerous changes) or oesophageal cancer at an early stage, improving the chances of successful treatment.

Can the risk of progression be reduced?

Yes. Managing acid reflux, adopting a healthy lifestyle, and following a treatment plan can lower the risk of complications. While Barrett’s oesophagus itself may not be entirely curable, many patients live symptom-free and avoid serious complications with effective management and routine follow-ups.

If you have chronic acid reflux or are concerned about Barrett’s oesophagus, consulting a specialist is crucial for early diagnosis and personalised treatment.