Our digestive tract is lined from mouth to anus by a very thin cellular layer called epithelium. The cellular type, composition and function differs to each other according to the area or the organ of the bowel.
The lining of the gullet or oesophagus is different to the lining of the stomach. Oesophageal lining can not withstand the acidic secretions of the stomach. The epithelium of the stomach and gut can withstand the acidic secretions of stomach. If you are having long standing acid reflux or GORD – Gastro Oesophageal Reflux Disease; the lining of oesophagus can change into the lining similar to bowel. This phenomena is called Barrettes oesophagus. This happens mostly due to reflux but can happen even without reflux as well. There are no specific symptoms due to this condition. However if one is having long standing reflux / heart burn; they need to undergo a camera test or an endoscopy. If your doctor notice any difference in the oesophagus he will take a small piece from this area to check under the microscope – a biopsy.
The biopsy report can report it as ‘Barrettes oesophagitis’. Most of these are benign but some can have early changes of cancer or may be pre cancerous. Ten percent those who have reflux can develop Barrettes and another one percent of them can develop cancer. Your doctor will ask you to come for follow-up endoscopes in 6 months to one year depending on the histology findings. You will be given medication to reduce acid secretion and to promote passage of food into gut.
If you are over weight will advice to reduce your weight as obesity is one cause of reflux, will advice to stop smoking, alcohol and caffeine – coffee, reduce spicy and oily food. You should not sleep within 3hrs of eating and raise the head end of your bed by about 6 inches. Exercise will help in promoting emptying of the stomach.
Barrettes changes can be revert back by preventing reflux and stopping smoking. May need Radio Frequency Ablation(RFA), laser therapy, cryo therapy with liquid nitrogen or carbon dioxide or EMR-Endoscopic Mucosal Resection. Sometimes you may need an extensive surgery to remove most of your oesophagus- Oesophagectomy.
Diagnosis of Barrettes does not mean you are going to get cancer but need close monitoring and proper management to prevent it from progressing to cancer.