Treatment for Barrett’s oesophagus

Treatment for Barrett’s oesophagus includes:

  • medicines to stop stomach acid
  • treatment to remove or destroy the abnormal cells

What is Barrett's oesophagus?

Barrett’s oesophagus means that some cells in the lining of your food pipe (oesophagus) have started to change. In a small number of people, these cells may develop into oesophageal cancer over a long period of time.

The cells lining the food pipe are normally flat. They’re called squamous cells. In Barrett's oesophagus they become more like the column-shaped cells in the lining of the stomach and bowel.

These cells may grow abnormally. Doctors call this dysplasia. The dysplasia can be low grade or high grade. The grade means how abnormal the cells look under a microscope. The more abnormal they look, the higher the grade.

What is the treatment for Barrett's oesophagus?

The management of Barrett's oesophagus depends on your situation. Management options include:

  • monitoring your condition - this is called surveillance
  • medicines to stop stomach acid
  • removing the affected area through an endoscope - this is called endoscopic mucosal resection (EMR)
  • destroying the affected area using radiofrequency ablation (RFA)
  • surgery to strengthen the food pipe valve

Monitoring your Barrett's

You need to see your specialist doctor regularly if you have Barrett's oesophagus.

You might also have regular tests called gastroscopies to look inside your food pipe. This checks whether the abnormal cells are developing. It can also pick up oesophageal cancer early when treatment is usually successful.

Whether you need gastroscopies depends on your condition and whether it is changing. Your specialist doctor will tell you more about this. 

Medicines to stop stomach acid

These medicines aim to control the symptoms of indigestion and heartburn. They include drugs called proton pump inhibitors such as omeprazole tablets.

You may need to keep taking these tablets as long as they control your symptoms. But you may be able to reduce the dose after a while.

An operation to remove the abnormal cells

Your doctor can remove abnormal areas from the lining of the food pipe or the stomach. This operation is called endoscopic mucosal resection or EMR.

Your doctor uses a long flexible tube (endoscope) with a tiny camera and light on the end to look inside your oesophagus. They put a thin wire called a snare down the endoscope. They use the snare to remove abnormal areas in the inner lining of the oesophagus.

Radiowave treatment to destroy abnormal cells

Radiofrequency ablation (RFA) uses heat made by radiowaves to kill abnormal cells. It is also called radiowave treatment.

Your doctor puts a probe down the endoscope. The probe creates an electrical current which heats the abnormal cells to high temperatures and destroys them.

You may have this treatment on its own. Or you may have RFA after endoscopic surgery to destroy any remaining abnormal cells in the area.

Strengthening the food pipe valve

A surgeon can sometimes strengthen the valve at the lower end of your oesophagus. This operation is called laparoscopic fundoplication.

It stops acid from the stomach going back up into the oesophagus and reduces indigestion and heartburn.

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

  • British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus
    RC Fitzgerald and others
    Gut, 2014. Volume 63. Pages 7–42

  • Revised BSG recommendation on the diagnosis and management of Barrett’s oesophagus with low-grade dysplasia
    British Society of Gastroenterology, 2017

  • Barrett’s oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management
    National Institute for Health and Care Excellence (NICE), February 2023

  • Endoscopic radiofrequency ablation for Barrett's oesophagus with low grade dysplasia or no dysplasia
    National Institute for Health and Care Excellence (NICE), July 2014

  • Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
    National Institute for Health and Care Excellence, 2014 (updated October 2019)

Last reviewed: 
16 Aug 2023
Next review due: 
17 Aug 2026

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