Barrett's oesophagus

Last reviewed: 29 Aug 2022
Last updated: 05 Apr 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • heartburn
  • regurgitation
  • dysphagia
More key diagnostic factors

Other diagnostic factors

  • chest pain
  • laryngitis
  • cough
  • Dyspnoea or wheezing
  • history of aspiration pneumonia
Other diagnostic factors

Risk factors

  • acid/bile reflux or GORD
  • increased age
  • white ethnicity
  • male sex
  • family history of Barrett's oesophagus or oesophageal adenocarcinoma
  • obesity
  • smoking
More risk factors

Diagnostic investigations

1st investigations to order

  • upper GI endoscopy with biopsy
  • Barium oesophagogram
More 1st investigations to order

Emerging tests

  • chromoendoscopy
  • autofluorescence imaging
  • confocal laser endomicroscopy
  • optical coherence tomography
  • spectroscopy
  • transnasal endoscopy
  • capsule endoscopy
  • gelatin-coated sponge

Treatment algorithm

ACUTE

non-dysplastic Barrett's oesophagus

low-grade dysplasia

high-grade dysplasia

Contributors

Authors

Andres F. Carrion, MD

Assistant Professor of Medicine

Medical Director of Gastrointestinal Endoscopy

Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

AFC is a scientific advisor for Intercept Pharmaceuticals and Gilead Sciences, and is on the speaker bureau for Bristol-Myers Squibb, Intercept Pharmaceuticals, Merck, and Alexion.

Marc J. Zuckerman, MD

Professor of Medicine

Chief

Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

MJZ declares that he has no competing interests.

Acknowledgements

Dr Andres F. Carrion and Dr Marc J. Zuckerman would like to gratefully acknowledge Dr Vic Velanovich, the previous contributor to this monograph.

Disclosures

VV is an author of a number of references cited in this monograph.

Peer reviewers

Richard E. Sampliner, MD

Professor

Medicine Chief

Department of Gastroenterology

University of Arizona College of Medicine

Tucson

AZ

Disclosures

RES declares that he has no competing interests.

Peter McCulloch, MBChB, MA, MD, FRCS (Ed), FRCS (Glas)

Clinical Reader in Surgery

Nuffield Department of Surgery

University of Oxford

Oxford

UK

Disclosures

PM declares that he has no competing interests.

  • Barrett's oesophagus images
  • Differentials

    • Oesophagitis
    • GORD
    • Oesophageal adenocarcinoma
    More Differentials
  • Guidelines

    • Guideline on informed consent for GI endoscopic procedures
    • Endoscopic eradication therapy for patients with Barrett’s esophagus–associated dysplasia and intramucosal cancer
    More Guidelines
  • Patient leaflets

    Sore throat

    Heartburn

    More Patient leaflets
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