Understanding Barrett’s Oesophagus

Welcome to our patient information page. This article provides general information about Barrett’s oesophagus. It is not a substitute for professional medical advice. Always consult your doctor or pharmacist before starting or stopping any treatment, and discuss any concerns about your health.

What Is Barrett’s Oesophagus?

Barrett’s oesophagus is a condition where the normal lining of the oesophagus (the tube that carries food from your mouth to your stomach) changes. The usual flat cells (squamous epithelium) are replaced by cells that look more like those in the intestine (columnar epithelium). This change usually happens because of long-term exposure to stomach acid, often due to gastro-oesophageal reflux disease (GERD).

Many people with Barrett’s oesophagus have no symptoms, and it is often discovered during tests for other reasons. While it is not cancer, it can increase the risk of developing oesophageal adenocarcinoma, a type of oesophageal cancer. However, this risk is low—most people with Barrett’s oesophagus do not develop cancer.

Causes and Risk Factors

The main cause is chronic acid reflux, where stomach acid flows back into the oesophagus, irritating the lining over time. Risk factors include:

• Long-standing GORD
• Being male
• Older age (over 50 years)
• Obesity, especially around the abdomen
• Smoking
• Family history of Barrett’s oesophagus or oesophageal cancer
• Caucasian ethnicity

In Australia, Barrett’s oesophagus affects a small percentage of the population, but awareness is important for those with persistent reflux symptoms.

Common Symptoms

Barrett’s oesophagus itself often causes no symptoms. When present, they are usually related to GERD and may include:

• Frequent heartburn or a burning sensation in the chest Acid regurgitation (sour taste in the mouth)
• Difficulty swallowing
• Chest pain
• Unexplained weight loss (in rare cases)

If you experience these, it does not necessarily mean you have Barrett’s oesophagus, but you should discuss them with your doctor.

Diagnosis

Diagnosis is made through an upper endoscopy (gastroscopy), where a thin, flexible tube with a camera is passed through the mouth to examine the oesophagus. During the procedure, small tissue samples (biopsies) are taken to check for the characteristic cell changes and any signs of dysplasia (pre-cancerous changes).

Your doctor may recommend this test if you have long-term reflux symptoms or other risk factors. Additional tests, like a barium swallow, are sometimes used but are less common.

Treatment and Management

There is no cure for Barrett’s oesophagus, but management focuses on controlling reflux and monitoring for changes:

• Lifestyle changes: Maintain a healthy weight, avoid trigger foods (e.g., spicy, fatty, or acidic foods), eat smaller meals, elevate the head of your bed, and quit smoking.
• Medications: Proton pump inhibitors (PPIs) like omeprazole to reduce stomach acid.
• Surveillance: Regular endoscopies to monitor for dysplasia. The frequency depends on the length of the affected area and presence of dysplasia—every 3–5 years for no dysplasia, more often if low-grade dysplasia is found.
• Endoscopic therapy: If dysplasia is detected, treatments like radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR) may be used to remove abnormal tissue.

Surgery is rarely needed unless complications arise.

Prevention

Preventing Barrett’s oesophagus involves managing GORD early:

• Seek treatment for persistent reflux symptoms.
• Adopt healthy lifestyle habits as mentioned above.
• Regular check-ups if you have risk factors.

Screening for Barrett’s oesophagus is not routine for everyone but may be considered in high-risk groups.

When to See a Doctor

Contact your doctor if you have ongoing heartburn, regurgitation, swallowing difficulties, or unexplained symptoms lasting more than a few weeks. For emergencies, such as severe chest pain, difficulty breathing, or vomiting blood, go to the nearest hospital or call triple zero (000) in Australia.

This information is based on general medical knowledge and is not intended to diagnose or treat any condition. For personalised advice, please consult a qualified healthcare professional.

References

• Weusten B, et al. (2025). Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. *Endoscopy*.
• Cancer Council Australia. (Accessed 2025). Barrett’s Oesophagus Clinical Guidelines. Available at: https://www.cancer.org.au/clinical-guidelines/oesophageal-cancer/barretts-oesophagus.
• Shaheen NJ, et al. (2024). AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett’s Esophagus and Related Neoplasia. *Gastroenterology*, 166(6), 1020–1055.
• Muthusamy VR, et al. (Accessed 2025). Barrett Esophagus. *StatPearls*. NCBI Bookshelf.
• Qumseya B, et al. (2024). American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the diagnosis and management of Barrett’s esophagus. *Gastrointestinal Endoscopy*.

These references were selected for their recency and relevance as of 2025. For the latest updates, check reputable sources like PubMed or Australian health authorities.