Barrett's Oesophagus

Key points

• Barrett's refers to the metaplasia of the lower oesophageal mucosa, with the usual squamous epithelium being replaced by columnar epithelium. There is an increased risk of oesophageal adenocarcinoma, estimated at 50-100 fold.
• the columnar epithelium may resemble that of either the cardiac region of the stomach or that of the small intestine (e.g. with goblet cells, brush border) Risk factors
• gastro-oesophageal reflux disease (GORD) is the single strongest risk factor
• male gender (7:1 ratio)
• central obesity Interestingly alcohol does not seem to be an independent risk factor for Barrett's although it is associated with both GORD and oesophageal cancer.