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Barrett's oesophagus is a condition in which there is gastric or intestinal metaplasia of the mucosa of the distal oesophagus.
- most often an acquired condition although it may rarely be congenital in origin,
- long-standing gastro-oesophageal reflux results in replacement of esophageal squamous mucosa with metaplastic columnar mucosa that confers a predisposition to cancer
- this process appears to cause the squamocolumnar junction (ora serrata) to migrate caudally
- cancer risk is thought to be low in oesophageal columnar tissue lacking intestinal metaplasia (1)
Barrett's oesophagus can be classified according to the segment of metaplastic columnar epithelium that replaces the stratified squamous epithelium normally lining the distal oesophagus:
- long segment Barrett's oesophagus – if the segment is >3cm
- short segment Barrett's oesophagus - if the segment is <3cm
- progression of Barrret’s oesophags to adenocarcinoma is thought to develop in a stepwise manner; following the sequence of oesophagitis, metaplasia, dysplasia, and finally adenocarcinoma (1)
Last reviewed 01/2018