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  • Q&A with Australian Health Practitioners

    How is Barrett's oesophagus treated?

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    Dr Michael Swan

    Gastroenterologist

    Michael Swan is a Gastroenterologist specialising in endoscopy, pancreaticobiliary disease and gastrointestinal cancer screening. Michael trained in clinical endoscopy with leaders in the field both … View Profile

    Barrett's oesophagus is a premalignant condition, meaning it is a known risk factor for (oesophageal) cancer. The extent of the risk is debatable as recent research has suggested that the risk might not be as high as previously thought. 
    Barrett's oesophagus can be classified as nondysplastic, low grade and high grade depending on the degree of dysplasia (changes towards cancer) on biopsy samples taken at endoscopy. The grade of dysplasia does affect the degree of risk of cancer development. 
    High grade dysplasia (HGD) has an approxiate rate of cancer development of 2-3% per year compared to low grade dysplasia (LGD) of 2-3% lifetime risk of cancer development. As such the overall benefit for treating HGD is much higher than LGD and nondysplastic Barrett's oesophagus. 

    Treatment of Barrett's oesophagus includes
    1. Removal of the Barrett's oesophagus
    a) endoscopic (via gastroscopy) removal - endoscopic mucosal resection
    b) surgical - oesophagectomy
    2. Ablation (destruction) of the Barrett's oesophagus
    a) radiofrequency ablation (RFA)
    b. argon plasma coagulation (APC)
    c. cryotherapy

    Treatment (and treatment outcome) is dependent on local expertise (skill and experience of the endoscopist or surgeon), degree of dysplasia, patient factors (such as other medical conditions) and availability of equipment.   

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