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 risk of developing oesophageal cancer?

Barrett's oesophagus can increase your risk of cancer of the oesophagus, although the risk is still small. Many people with Barrett’s oesophagus do not develop cancer.

Between 3 and 13 people out of 100 (between 3 and 13%) with Barrett’s oesophagus in the UK will develop oesophageal adenocarcinoma in their lifetime. And each year, less than 1 in 100 people with Barrett’s (less than 1%) develop oesophageal adenocarcinoma. Your risk of developing oesophageal cancer is higher if you have more severe cell changes (high grade dysplasia). 

Risks and causes

Barrett's oesophagus is more common in men than women. And it is also more common in older people. Other risk factors include:

• having a history of acid reflux symptoms
• being overweight and your fat being mainly around your waist (abdominal obesity)

Symptoms

Many people with Barrett’s oesophagus don’t have any symptoms. Doctors may find the changes in the cells when you have tests for something else.

Long term indigestion and heartburn is the most common symptom. Many people have these symptoms and it doesn’t usually mean anything is wrong. But see your GP to get checked if you have indigestion or heartburn that doesn't go away.

You may also have difficulty swallowing food. Or food may come back up from the stomach into the food pipe but this is less common.

Tests and monitoring for Barrett's oesophagus

You will have tests to diagnose and monitor your Barrett's oesophagus. These include:

• gastroscopy
• capsule sponge test

How often you have tests depends on your condition and whether it is changing. Your specialist doctor will tell you more about this.

Gastroscopy

Your doctor will send you for an gastroscopy if they think you might have Barrett’s oesophagus. This test looks inside your food pipe to find any changes. It uses a long flexible tube with a light on the end.

Capsule sponge test such as Cytosponge or EndoSign

A capsule sponge test is a small capsule which you swallow, along with a drink of water. The capsule contains a sponge that is attached to a string. The sponge is covered in gelatine which takes about 5 minutes to dissolve in your stomach. The nurse then gently removes the sponge by pulling the string. As they pull the sponge up and out of your mouth, it collects cells from the lining of your oesophagus. The nurse sends the sponge to the laboratory.

There are different capsule sponge products. They include Cytosponge and EndoSign.

In Scotland, the capsule sponge test is used to diagnose and monitor some people with Barrett’s oesophagus. 

There are trials and projects taking place in different parts of England and Wales. They are looking at the use of this test in people with symptoms and those with a diagnosis of Barrett’s oesophagus. If these are successful, the capsule sponge test might be used more widely in the NHS for people with Barrett’s oesophagus.

Treatment

Some treatments aim to control symptoms and reduce the risk of the abnormal cells developing into cancer. They lower the amount of acid the stomach produces.

Other treatments remove or treat the damaged areas in the lining of the food pipe.

Coping

It can be difficult to cope with knowing that you have Barrett’s oesophagus. You may worry about the chance of developing cancer. Finding out about the condition and its treatment can help you to feel more in control.

Talk to the Cancer Research UK information nurses on freephone 0808 800 40 40. Lines are open from Monday to Friday, 9am to 5pm.

You can find people to share experiences with online on our CancerChat forum.