Why do an Endoscopy Procedure in Patients with Barrett’s Oesophagus?
Doctors need to know whether a person with Barrett’s oesophagus is at risk of developing cancer. The best way to do this currently is endoscopy – to look inside with a flexible tube which has a video camera built in.
During the endoscopy test, the doctor can take small samples from the lining of the oesophagus. These are called biopsies. The biopsies are sent to the pathologist who will examine them and determine whether dysplasia is developing. Dysplasia is the most powerful sign that an individual is moving along the pathway to developing cancer.
Should People with Barrett’s have Regular Endoscopic Surveillance?
All the major international specialist groups including the British Society of Gastroenterology recommend regular endoscopy for people with Barrett’s oesophagus. The reason is simple. It allows doctors to spot early changes in cells as they move to being cancerous.
Remember – the vast majority of people with Barrett’s oesophagus never actually get cancer. But if they do, early detections means the cancer can still be treated. There is plenty of evidence that people who have regular endoscopies have a higher chance of cure even if they develop cancer.
It is also now possible to treat people before cancer develops. This is only appropriate in some people. It is possible to assess who would benefit from this type of treatment by analysing the biopsy samples taken at endoscopy .
There is some uncertainty, however. Since most people with Barrett’s oesophagus never get cancer, it is not absolutely clear that everyone should have surveillance.
How Often to Survey?
The British Society of Gastroenterology issued new guidance in 2013.
The new guidelines divide sufferers into those with
For patients with short segment Barrett’s, they sub-divide into
Recommended Surveillance Intervals
Who should do the endoscopy procedures?
This should be easy to answer. All gastroenterologists are trained to do endoscopy to a high standard. So are nurse endoscopists. So, surely anyone can do this well?
Well, actually, our experience is that this is simply not true. Endoscopic surveillance of Barrett’s oesophagus is a specialist procedure. Many general endoscopists do not do it particularly well.
Common mistakes doctors can make at endoscopy include:
How should it be done?
High quality surveillance requires all of the following:
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We recommend that endoscopy procedures should be undertaken by experts. We offer this service. Make an appointment with one of our specialists who will be able to advise you. Please tell our office staff that you want to see an expert in Barrett’s oesophagus. We will ensure you see the right person.