In Barrett's oesophagus, affected cells undergo a transformation

There is a very small increased risk of developing oesophageal cancer if you have Barrett’s oesophagus. — 123rf.com

I recently went for a routine upper endoscopy, where the gastroenterologist did a check of my stomach and surrounding areas via a scope. The doctor then told me that I had a condition called Barrett’s oesophagus. What is this?

Barrett’s oesophagus is a condition in which the pink lining of your oesophagus – the long tube that connects your mouth to your stomach – is damaged by constant acid reflux from your stomach contents.

This causes the lining of your oesophagus, especially the lower part of it, to thicken and become red.

This happens because there is a lining (epithelial) change from the normal squamous cells to columnar cells, which are more akin to your stomach’s cell lining.

In other words, the lower part of your oesophagus has become like your stomach in order to withstand the constant acids swirling there.

Why has this happened?

Between your oesophagus and your stomach is a very important valve, the lower oesophageal sphincter.

As you get older, this valve may begin to fail.

This leads to stomach acid leaking into your oesophagus, especially after you eat a large meal or do anything to cause reflux of your stomach acids.

This gastroesophageal reflux disease (GERD) then causes chemical damage of your oesophagus and triggers a lining cell change.

This change is called Barrett’s oesophagus.

Usually, you will have symptoms of GERD like heartburn or regurgitation.

Sometimes, you may have difficulty in swallowing, or even on rare occasions, chest pain.

But in half of all the people who have Barrett’s oesophagus, this reflux is “silent” and you don’t even realise you have it at all.

That is, until you go through a routine check-up gastroscopy like the one you did, and the doctor incidentally finds Barrett’s oesophagus.

Is this Barrett’s oesophagus dangerous? I don’t think I like the idea of my oesophagus becoming like my stomach!

Don’t worry, your oesophagus will not become like your stomach!

It will not perform the functions your stomach does.

However, Barrett’s oesophagus is associated with an increased risk of developing oesophageal cancer.

It has to be mentioned that this risk of developing oesophageal cancer is small – less than 1%.

Most people with Barrett’s oesophagus do not ever develop oesophageal cancer.

But what you have to do is go for regular check-ups with gastroscopes at least once in every 1.5 to two years to monitor for pre-cancerous cells (dysplasia).

Biopsies (i.e. small samples of your oesophageal lining) may have to be taken during these scopes if the doctor sees anything suspicious.

If any pre-cancerous cells are discovered, they can be immediately treated to prevent the development of oesophageal cancer.

OK, I am confused. I got Barrett’s oesophagus even though I never felt anything in all my life. However, my wife, who also had a routine gastroscope, has had heartburn most of her adult life, but does not have Barrett’s oesophagus. Why is this?

No one quite knows why some people get it and others don’t.

But there are several risk factors for Barrett’s oesophagus:

• Family history – if your parents or someone in your family has a history of Barrett’s oesophagus or oesophageal cancer.
• Male
• Age – it is more common in adults over 50; that is why it is always good to get a routine scope once you pass 50 years of age.
• Chronic heartburn and acid reflux – even if you are already on long-term medications for heartburn, you can still get Barrett’s oesophagus.
• Current or past smoking
• Being overweight – fat around your abdomen further increases your risk.
• Caucasian – white people have a greater risk compared to other races.

Can I do anything to reverse my Barrett’s oesophagus?

Apparently, there are some new techniques that can help accomplish this.

According to a report, 70% of Barrett’s oesophagus patients treated with multipolar electrocoagulation or argon plasma coagulation will have a complete reversal of the condition for at least two years.

But because the risk of developing oesophageal cancer is so small, most doctors will just tell you to leave it and get it checked once every two years.

The risk of the surgery and its complications may not be worth it.

What about non-surgical means?

You need to treat Barrett’s oesophagus like you would treat GERD. You can then slow down its progression.

You can control your acid reflux by changing your lifestyle, as well as with certain medications.

Avoid fatty foods, alcohol, chocolate, caffeine (coffee, tea, soft drinks), spicy foods and peppermint as these can all aggravate reflux.

Do not smoke.

Lose weight if you are overweight.

Sleep with your head elevated in order to prevent acid from flowing up into your oesophagus.

Do not have eat too close to bedtime or lie down for two or three hours after eating.

Eat smaller meals throughout the day instead of big meals.

You can also take antacids and other medications for GERD if your doctor prescribes them.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.