Gastroenterology and hepatology
Barrett's oesophagus
What counts as Barrett oesophagus, cancer risk by grade, surveillance intervals by segment length, confirming dysplasia, endoscopic eradication for dysplasia and early cancer, and PPI chemoprevention.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Barrett oesophagus is replacement of squamous mucosa in the distal oesophagus by columnar epithelium with intestinal metaplasia. It is the precursor of oesophageal adenocarcinoma.
- Most patients have non-dysplastic Barrett (NDBE), with an annual cancer risk of about 0.1 to 0.3%. Most die of something else.
- Management turns on dysplasia grade, confirmed by a second expert pathologist: surveillance for NDBE, endoscopic eradication therapy (EET) for confirmed dysplasia and intramucosal cancer.
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Sources
- Wani S et al. AGA Clinical Practice Guideline on Surveillance of Barrett's Esophagus. Gastroenterology 2025;169:1184-1231American Gastroenterological Association, 2025
- Rubenstein JH et al. AGA Clinical Practice Guideline on Endoscopic Eradication Therapy of Barrett's Esophagus and Related Neoplasia. Gastroenterology 2024;166:1020-55American Gastroenterological Association, 2024
- Shaheen NJ et al. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol 2022;117:559-87American College of Gastroenterology, 2022
- Weusten BLAM et al. Diagnosis and management of Barrett esophagus: ESGE Guideline. Endoscopy 2023;55:1124-46European Society of Gastrointestinal Endoscopy, 2023
- Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management (NG231)National Institute for Health and Care Excellence, 2023
- Clinical practice guidelines for the diagnosis and management of Barrett's oesophagus and early oesophageal adenocarcinomaAU/NZCancer Council Australia, 2014
- Phoa KN et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia (SURF). JAMA 2014;311:1209-17JAMA, 2014
- Jankowski JAZ et al. Esomeprazole and aspirin in Barrett's oesophagus (AspECT). Lancet 2018;392:400-8Lancet, 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy