Complications

Managing complications 

Most people with Barrett’s Oesophagus suffer nothing other than heartburn. A few people may get inflamed ulcers in their oesophagus.

Barrett’s ulcers
These are due to a breakdown in the gullet lining. You may experience:

    • chest pain
    • pain swallowing
    • unusual stools – black, tarry or bloody
    • vomiting red blood or blood that looks like coffee grounds
    • symptoms of anaemia such as lethargy

Barrett’s ulcers are diagnosed by endoscopy. This means using a tiny camera to examine your gullet and stomach. Treatment may include increasing your acid lowering medications or surgery to prevent reflux of acid. If you are anaemic this may be treated with iron tablets or a blood transfusion.

Stricture
This is a narrowing in the gullet that may cause:

    • difficulty swallowing (dysphagia)
    • an unexpected drop in weight

If you develop these symptoms you should see your doctor.

A stricture may be diagnosed by performing an endoscopy or a barium swallow. In a barium test you drink a dense liquid called barium and X-rays are taken as it passes through your gullet and stomach.

Strictures are treated by stretching the narrowed gullet. This involves an endoscopy, usually under X-ray control, and then a tube or balloon is passed down to stretch the gullet. It is also necessary to reduce your acid reflux to prevent the stricture reforming. This is achieved by increasing your dose of acid lowering medications or occasionally by surgery.

Pre-cancerous change (dysplasia)
In a very small number of patients Barrett’s Oesophagus can gradually lead to cancer of the gullet or upper stomach. This may take many years to develop and is usually preceded by a further cell change within the Barrett’s lining to abnormal appearing cells (dysplasia). These are best diagnosed by examining small tissue samples under the microscope.

The abnormal cells are thought to progress through low grade dysplasia to high grade dysplasia before becoming cancerous.

It can, however, take up to 10 years for dysplasia to develop into cancer although, in some people, cancer may have already started developing within the area of high-grade dysplasia at the time it is diagnosed.

This gradual progression explains why an increasing number of hospitals perform endoscopies at regular intervals. The aim is to detect any dysplasia before it progresses to cancer.