A few facts about Barrett's.

1. Barrett's is not an illness. It is the addition of cells to the lower oesophagus to protect against acid erosion.

2. Although most people have never heard of it until diagnosed, it is probably far more common than we realise. The Mayo clinic in US suggests there could be as many as 1 in 20 with the condition, accounting for possibly as many as 3 million in UK though fewer than 150,000 know it.

3. Barrett's is permanent, unless it is removed by a process called ablation (and even then it could recur).

4. Barrett's has no symptoms. In fact, because Barrett's cells are less sensitive, it actually helps reduce pain which may be felt from the oesophagitis that contributed to its formation.(If you have oesophagitis causing pain, it usually heals in a couple of weeks with appropriate medication.)

5. The reason that Barrett's is significant is the cells, being alien to the oesophagus, have the potential to mutate to cancer. Oesophageal Adenocarcinoma is the fourth greatest cancer killer of men in the western world claiming the lives of one person an hour on average in UK. The risk to those with Barrett's is about 1 in 400 each year. However, it is most likely to affect those who have not been previously diagnosed as, once diagnosed it can be managed to significantly reduce or remove that risk.

6. Barrett's will not spread and the longer you have it, the less likely it is to mutate.


Management of Barrett's.

There may be many factors why you developed Barrett's. The most obvious one is reflux of acid from the stomach into the oesophagus causing damage (oesophagitis) which some experience as heartburn.

1. Reducing the acid will mean material refluxing from the stomach is less damaging. This has to be done with medication using either an "H2 blocker" (eg ranitidine) or, better, a "Proton Pump Inhibitor (PPI)" (eg omeprazole). Although many suggest it, your diet doesn't actually affect this as the acidity of your stomach is controlled by hormones, not food, but avoiding foods that cause you a problem may help any oesophagitis heal. Those of us with Barrett's are recommended to remain on PPIs for life. There is much evidence to show it significantly reduces the risks of development of the cancer.

2. Reducing reflux has to be managed by lifestyle modification or surgery. Drugs will not help this mechanical action. Lifestyle modification may mean losing weight (if necessary), stopping smoking (if appropriate), eating smaller meals (little and often), avoiding exercise after food that compresses, tilts, or shakes the stomach, avoiding tight clothing, leaving at least 3 hours between your last meal and going to bed, raising the head of the bed by 15 - 20cm (6 - 8 inches) on blocks so gravity will help any residue in the stomach remain there.

3. Regular surveillance scopes. Depending on size of the Barrett's lesion, familial history, body type and other identified risk factors, you should have an endoscopy usually anything from every 2 to 5 years. This will look for any pre-cancerous changes, called dysplasia, whence ablation treatment may be offered.