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DIAGNOSING BARRETT’S OESOPHAGUS REFLUX TESTING AND TREATMENT

To diagnose Barrett’s oesophagus, your physician will need to perform an upper endoscopy.

IMPORTANCE OF EARLY DETECTION

Over 25 percent of gastro-oesophageal reflux disease (GORD) patients may progress to Barrett’s oesophagus in their lifetime.1 Barrett’s oesophagus is the primary risk factor for oesophageal adenocarcinoma, a type of oesophageal cancer.2-4

Barrett’s is more likely to occur in patients with certain risk factors, such as having frequent acid reflux symptoms, being obese, using tobacco, or having family history of Barrett’s or oesophageal cancer.3,5 If you experience frequent GORD symptoms and have been regularly using medications to control heartburn for several years, speak to a gastroenterologist (GI) about screening for Barrett’s.

Doctor examines chest of male patient.

HOW IS BARRETT’S OESOPHAGUS DIAGNOSED?

Barrett’s oesophagus cannot be diagnosed by symptoms. Diagnosing Barrett’s is dependent on an upper endoscopy performed by a GI or surgeon. This procedure enables the physician to directly visualise the oesophagus and take tissue samples.

ENDOSCOPY WITH BIOPSY PROCEDURE

An endoscopy is a procedure performed under sedation that allows the physician to directly visualise oesophageal tissue and identify any abnormal tissue. An endoscope is a thin, flexible tube with a small camera attached. During the procedure, the endoscope is guided down the throat to inspect the oesophagus and capture pictures of the tissue.

Your physician will also perform a biopsy and collect a small tissue sample for further examination. This sample will be used to determine if there is dysplasia (abnormal cell growth) present in the lining of your oesophagus.

Your tissue sample will be classified into one of the following:

  • Intestinal Metaplasia Without Dysplasia: Barrett’s oesophagus is present, but no precancerous changes are visible in the cells of your oesophageal lining.
  • Low-Grade Dysplasia: Cells show early signs of precancerous changes that could lead to oesophageal cancer.
  • High-Grade Dysplasia: Oesophagus cells display a high degree of precancerous changes, thought to be the final step before oesophageal cancer.

STAGES OF BARRETT’S OESOPHAGUS

Normal, healthy esophagus

Normal, healthy oesophagus  

 

Esophagus affected by low-grade dysplasia (LGD)

Low-grade dysplasia
 

Esophagus damaged by erosive esophagitis (EE), prolonged acid exposure

Oesophagus damaged by prolonged acid exposure

Esophagus affected by high-grade dysplasia (HGD)

High-grade dysplasia
 

Esophagus progressed to nonplastic Barrett's esophagus (NBDE)

Non-dysplastic Barrett’s oesophagus

 

Esophagus suffering esophageal adenocarcinoma

Oesophageal adenocarcinoma
 

1

Dymedex Market Development Consulting, Strategic Market Assessment, GERD, October 30, 2014. References 1-3, 6-15, 22, 23, 25, and 34 from the full citation list, access at http://www.medtronic.com/giclaims

2

De Jonge PJ, van Blankenstein M, Looman CW, Casparie MK, Meijer GA, Kuipers EJ. Risk of malignant progression in patients with Barrett’s oesophagus: a Dutch nationwide cohort study. Gut. 2010;59:1030-6.

3

Spechler S. et al. Barrett’s Esophagus. N Engl J Med 2014; 371:836-45.

4

Hvid-Jensen F, Pedersen L, Drewes AM, Sorensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365:1375-83.

5

Evans JA et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointestinal Endoscopy. 2012;27(6):1087-1094