Skip over main navigation
  • Log in
  • Basket: (0 items)
Heartburn Cancer UK
Donate
  • Twitter
Menu
  • About us
    • What we do
    • Our history
    • Our team
    • Our trustees
    • Our patrons and ambassadors
  • Information
    • Persistent heartburn
    • Barrett's oesophagus
    • Dysplasia
    • Oesophageal cancer
    • Diet & lifestyle
      • Meet Sarah - our Dietitian in Residence
      • Dietary changes after Oesophagectomy - What can I expect?
      • Dumping Syndrome
      • Information for those with acid reflux
      • Oesophageal Cancer - eating when swallowing is difficult
    • Information booklet
  • Support Groups
    • Barrett's and Oesophageal Cancer Online Support Group
    • Basingstoke Support Group
    • East Anglia Support Group
    • HCUK London Barrett's Support Group
    • HCUK London Oesophageal Cancer Support Group
    • Start a support group in your area
    • Other Support Groups
  • Your stories
  • Get Involved
    • Share your story
    • Appeals
      • Early diagnosis - Saving lives
      • The Burning Question...
    • Fundraise for us
      • Events
      • Fundraising ideas
      • Create a fundraising page
      • Fundraisers
    • Book a holiday with Charitable Travel
    • Buy your greetings cards
    • Volunteer
    • Giving in memory
    • Legacy giving
    • Other ways to give
  • Shop
  • Latest
    • Blogs
      • Words of wisdom from Dr Oliver
      • Malcolm's magic with food
    • Events
    • In The Press
    • News
    • Newsletters
    • Research
      • Add-Aspirin Trial
      • Cytosponge
      • LINACRE Trial
      • Mutographs Project
  • Events
  • Get in touch
  • 01256338668
    • Log in
  • Basket: (0 items)
  • Barrett's oesophagus
  1. Information
  2. Barrett's oesophagus

Barrett's oesophagus

Blue Man

Everything you need to know…and more.


Essential information about…Barrett’s oesophagus 

  • What is Barrett’s oesophagus?
  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Useful information and where to find help and support.

What is Barrett’s oesophagus?

The oesophagus is the muscular tube that carries food from the mouth to the stomach, it is also known as the food pipe or gullet.

When people talk or write about Barrett’s oesophagus, the name is sometimes shortened to just ‘Barrett’s’.

Barrett’s is a ‘potentially precancerous condition’, where some of the normal cells in the lining of your oesophagus have changed to be ‘abnormal’ and more at risk of turning into cancer.

It does not mean you have cancer. But it can be a warning sign.

A small number of people who develop Barrett’s go on to develop oesophageal cancer. 

Most people with Barrett’s don’t develop this cancer. But if you have it, your doctors will probably want to give you some medication, keep a closer eye on you and/or send you for some treatment.

The main symptoms…what should I look out for?

The main symptom of Barrett’s oesophagus is reflux, also known as gastro-oesophageal reflux disease (GORD). This is where acid or juices from the stomach or small intestine escape and flow back up into the oesophagus, which often gives people heartburn. 

It can also: 

  • Make people feel sick (nauseous).
  • Give them a sour, acidic or metallic taste in their mouth.
  • Cause people to bring back up partly digested food (regurgitation).
  • Give people a hoarse voice or a chronic sore throat.
  • Some patients also complain of pain in the upper abdomen.

Reflux or heartburn is often worse first thing in the morning, or when lying down. 

It can also wake people up at night. 

If this happens, you should contact your doctor because it’s a commonly reported symptom for people with Barrett’s.

Unfortunately, people often treat these symptoms without going to the doctor. 

They buy over-the-counter antacids (such as Gaviscon or Rennie) from the supermarket or chemist instead. But this can mask a problem and delay the Barrett’s being found, treated, or monitored.

Anyone with heartburn (or any of the other listed symptoms) - regularly for three weeks or more - should always contact their doctor.

What causes it? 

The ‘abnormal cells’ found in the lining of the oesophagus, which is the main feature of Barrett’s, usually come from the point where the oesophagus meets the stomach.

They develop as the lining heals after being damaged by the misplaced stomach acid or bile.

As the body repairs, it creates stomach or intestine lining cells, not normal oesophagus lining cells.

Over time, these changed cells can develop into something called dysplasia, which is a precancerous condition.

Although, again, not everyone who has dysplasia will develop cancer. It simply increases the risk.

No one knows exactly why these cell changes happen, but it is closely linked with having gastro-oesophageal reflux disease (GORD) for a long time.

GORD is where the reflux - stomach juices that flush back up into the oesophagus inflame and damage the lining of the oesophagus. 

About 1 in 10 people with GORD will develop Barrett’s oesophagus.

The risk of developing Barrett’s increases with how long you’ve had a problem with reflux/GORD, how often you have symptoms and how severe those symptoms are.

How is it diagnosed?

To diagnose Barrett’s, doctors need to know what’s happening to the cells in the lining of your oesophagus.

They usually do this in three ways.

  1. With an endoscopy (gastroscopy) This is where a camera on a thin tube (about the width of a little finger) is passed down your throat. This can be done with or without sedation. If anything concerning is found, a few cells will be taken from that area (a biopsy), and sent to the lab to be checked.
  2. Using The Cytosponge™ This is where you swallow a pill on a strong thread (the size of a large vitamin pill).  You swallow the coated capsule, and it sits in your stomach for seven minutes to allow it to dissolve.  A nurse then quickly and gently pulls the thread, and the sponge then travels up the oesophagus collecting cells. The cells are sent to the lab to be checked. You might also be sent for a follow-up endoscopy if the lab finds anything abnormal. This new technique is currently only available in a few areas. But it should be more widely available in the future.
  3. Trans Nasal Endoscopy (TNE) This is sometimes offered as a way to investigate symptoms.  This is similar to an endoscopy/gastroscopy but instead of a camera going down your throat the camera will go up through your nostril. 

Author: Dr Sarmed Sami, Consultant Gastroenterologist at University College London Hospitals NHS Trust

He also works as a private Gastroenterologist based in central London at Digestive Health UK

How is it treated?

Treatment options are normally based on four things:

1.    The stage and location of the Barrett’s. 

2.    How big the area affected is.

3.    Your own health history. 

4.    Your family health history.

Common treatment options

If you have Barrett’s, you may be offered a combination of these treatments.

Treatments to deal with the abnormal cells or damage in the oesophagus.

1. Intense surveillance (active watching)

If you have Barrett’s, you will sometimes be monitored closely by having regular endoscopies. The decision on how often to undertake surveillance is based on a discussion between the patient and the hospital who diagnosed the Barrett’s. 

  • Doctors will check that the cells haven’t changed into something more concerning, such as early-stage cancer, which may need more extensive treatment.
  • Early diagnosis improves the chance of a good outcome.

Sometimes, people will be offered procedures that treat or remove the damaged segment of the oesophagus.  

2. EMR - endoscopic mucosal resection

This is where a doctor will remove abnormal cells from the inside of the oesophagus in a similar way to the camera test used to look for the cancer.  This may need to be done more than once.

  • EMR treats the abnormal area by removing pre-cancerous cells, or small areas of cancer, without major surgery.
  • A scar will form on the area where the cells have taken. But this normally heals on its own. However, people often feel uncomfortable in the chest and have some pain when swallowing for the first two or three days.
  • If someone feels pain for longer, or if they find it difficult to swallow food, they may need another endoscopy to stretch the scar. This happens to about 1 in 20 patients.
  • There is also a risk of bleeding after an EMR (this happens in about 1 in every 500 cases). This bleeding will usually stop by itself, but observation and further treatment in hospital may be needed. Rarely (in about 1 in 200 cases) a small hole in the lining of the oesophagus develops (this is called a perforation). This means you would have to go into hospital for antibiotics and artificial feeding and possibly an operation to repair any damage. 

3. RFA - radiofrequency ablation

This is a treatment, which uses radiofrequency, a type of heat therapy to treat the area of Barrett’s oesophagus. The treatment is given during an endoscopy procedure and patients go home the same day. It’s quite usual for people to have more than one treatment to deal with all abnormal cells.

  • RFA means that the abnormal cells are removed by being burnt away.
  • It’s been used in the UK, Europe and the US for many years and is now the recommended first treatment for severe (high-grade) and less severe (low grade) Barrett’s.
  • It is done under sedation and is very safe and effective at removing abnormal cells, but it can only be used on flat areas. EMR will first be used to remove anything that is raised.
  • The technique is often called by the name of the device used. This includes HALO® RFA or Barrx®.

Treatments to try and stop the acid from reaching the oesophagus (and doing more damage)

1. Medication to reduce the acid level in your stomach.

  • Doctors often give people with Barrett’s a kind of medication called PPIs, which stands for Proton Pump Inhibitors.
  • Common ones are omeprazole and lansoprazole. But there are others too.
  • These reduce the amount of acid in the stomach the body produces, and therefore make it more difficult for it to flush back up the oesophagus.

2. Lifestyle changes

  • Being overweight or obese, drinking alcohol and smoking can all affect acid reflux. Making some changes to your lifestyle can make a difference.
  • People can also make improvements by cutting down their portion sizes, taking more exercise and not eating within three hours before they go to bed. You can find more information about this on our diet and lifestyle page.

3. Surgery called a Laparoscopic Anti-reflux Surgery (LARS) - Also known as Nissen Fundoplication

  • If medication and lifestyle changes don’t help, doctors sometimes consider something called a laparoscopic anti-reflux surgery. This is where the upper part of the stomach is stapled around the lower part of the oesophagus, making a better seal.

Extra things you might find useful.

More about the oesophagus

The oesophagus (which is pronounced o-sof-a-gus) is the muscular tube that joins the mouth and the stomach and is sometimes called the food pipe or the gullet.

This tube is normally lined by a layer of short, flat cells, called squamous cells.

This lining is similar to skin. It is multi-layered and protects the oesophagus from injury caused by swallowed food and stomach acid.

The oesophagus is not designed to cope with regular exposure to the strong acid or bile in the stomach. It’s when this acid gets misplaced that causes many of the main health issues, including inflammation, damage, cell changes and cancer.

Useful Information

  • National Institute for Healthcare and Care Excellence (NICE) guidelines on Barrett’s oesophagus and Stage one oesophageal adenocarcinoma: Monitoring and Management.
  • Link to a podcast by RefluxUK featuring a fascinating discussion about Barrett's oesophagus and with HCUK trustee, Professor Rebecca Fitzgerald as well as DR Jason Dunn.  Both are leading experts in this field.  The podcast is immensely helpful for those who have been newly diagnosed and contains plenty of interesting information even for those with more understanding. 
  • Just diagnosed – please take a read of our Barrett’s factsheet here.

Where to find help and support 

Receiving a new diagnosis is sometimes a daunting experience and you are bound to have questions.  Talking to others in similar situations can be helpful.  Heartburn Cancer UK has an online support forum for patients with Barrett’s and oesophageal cancer. The link to join the closed group is here. 

We also have two support groups based in London.  A group for those with Barrett's based out of UCLH and Chase Farm for those diagnosed with oesophageal cancer.  We have one in East Anglia (based out of Addenbrooke’s Cambridge) and also Basingstoke, Hampshire. For information on other groups outside of our organisation, click here.

Who is Heartburn Cancer UK?

   

Published: 23rd April, 2020

Updated: 17th May, 2023

Author: Nikki Foulkes

Share this page
  • Email
  • Facebook
  • Twitter

Latest

  • Walk The Test Way

    Walk The Test Way

    Like Heartburn Cancer UK the Walk the Test Way walk is 20 years old this year. Choose to walk one of five distances from 5 to 25.5 miles along the beautiful Test Way to raise vital funds that support the ongoing life saving work we do.

  • 19 year old Tobias Walks from Lands End to John O'Groats

    19 year old Tobias Walks from Lands End to John O'Groats

    Over the coming months Tobias will be walking from Lands End to John O'Groats in memory of a dear friends father who died of oesophageal cancer.

  • Nicola's Story

    Nicola's Story

    Nicola was diagnosed with Barrett's in her 20's and, following years of monitoring, was diagnosed with oesophageal cancer in early 2021. Here, Nicola shares her story to advise others on the things she has learnt from her experience.

  • Family Pay Tribute to Their Remarkable Clara

    Family Pay Tribute to Their Remarkable Clara

    Following issues with heartburn and reflux, Clara was diagnosed with oesophageal cancer in October 2021. Sadly, she passed away in March this year.

Most read

  • Oesophageal cancer

    Oesophageal cancer

    Oesophageal cancer - Early Symptoms, Causes, Prognosis, Prevalence, Diagnosis and Treatment

  • Persistent heartburn

    Persistent heartburn

    Heartburn is a burning sensation behind the breast bone, usually caused by acid and/or bile reflux. It is a common symptom - however - if you have suffered from heartburn for more than three weeks and regularly have to take off-the-shelf medicines to relieve it, you should talk to your doctor.

  • Barrett's oesophagus

    Barrett's oesophagus

    Barrett’s oesophagus, often known as just Barrett’s, is a condition that affects the lining of the oesophagus. Cancer of the oesophagus is more likely in people who have Barrett’s.

  • Information for those with acid reflux

    Information for those with acid reflux

    Simple food and lifestyle tips from our resident dietitian that may help to reduce acid reflux and heartburn symptoms

  • Giving in memory

    Giving in memory

    Giving in memory of someone special can be a positive way to celebrate their life, as well as being of great comfort to friends and family. Our tribute funds create a lasting memorial to your loved one and are completely personal to you.

  • LINACRE Trial

    LINACRE Trial

    The Oxford Clinical Trials Unit are applying for funding for an exciting new clinical trial for patients with Barrett’s Oesophagus. Recruited patients will be randomly selected to either continue with life long medication or have a device, called a LINX, fitted at the base of the oesophagus to reduce the symptoms associated with Barrett's.

  • Newsletters

    Newsletters

    Visit our Heartburn Cancer UK newsletter page to read at our current and historic editions.

  • Basingstoke Support Group

    Basingstoke Support Group

    Welcome to the homepage of the Barrett's, Stomach and Oesophageal Cancer support group based in Basingstoke, Hampshire.

  • Buy your greetings cards

    Buy your greetings cards

    Browse a selection of over 1300 greetings cards from our partner, Making a Difference Cards, and raise funds for Heartburn Cancer UK whilst letting your loved ones know that you care.

  • Danny's Story

    Danny's Story

    Danny lost his short battle with oesophageal cancer on the 21st February 2021. His family want to share his story to encourage others to seek medical advice if they have any health concerns.

Sign up for our newsletter

Please enter your first name
Please enter your last name
Please enter your email address Please enter a valid email address (e.g. [email protected])

Find us

Registered Office
Grove House
Lutyens Close
Chineham Court
Basingstoke
Hampshire
RG24 8AG

+44 (0)1256338668
[email protected]

Links

  • Sitemap
  • Accessibility
  • Terms & Conditions
  • Privacy Policy

Follow us

  • Facebook
  • Twitter
  • Linkedin
  • Instagram
  • Youtube

Heartburn Cancer UK is registered in England & Wales. Company Limited by Guarantee. Company Registration Number: 07227937
Charity Registration Number: 1136413

Manage Cookie Preferences