Barrett’s oesophagus: diagnosis and management

Barrett's oesophagus is a premalignant condition where the oesophageal squamous epithelium undergoes columnar change with metaplasia which predisposes to the development of oesophageal adenocarcinoma. In order for Barrett's oesophagus to be diagnosed, a segment of the lower oesophagus has to be replaced by columnar tissue (fig 1?). In patients with oesophageal columnar tissue without intestinal metaplasia the cancer risk is thought to be low. Many patients with Barrett's oesophagus have no symptoms. Development of oesophageal adenocarcinoma is understood to progress in a stepwise manner following the sequence of oesophagitis, metaplasia, dysplasia, and finally adenocarcinoma (fig 2?). This review describes how Barrett's oesophagus is diagnosed and explores questions regarding current and future management strategies for Barrett's oesophagus. References