Barrett’s Oesophagus

Medically written by
A/Prof Viraj Kariyawasam
MBBS, FRACP, MRCP, PhD
Gastroenterologist & Hepatologist
Associate Professor – Macquarie University
Head of IBD Service – Blacktown Hospital
Last reviewed: March 2026

1. What is Barrett’s Oesophagus?

Barrett’s oesophagus is a condition in which the normal lining of the lower oesophagus is replaced by a different type of tissue as a result of long-standing acid reflux. This change is known as intestinal metaplasia.

Barrett’s oesophagus itself does not cause symptoms, but it is important because it increases the risk of developing oesophageal cancer over time. Most people with Barrett’s oesophagus never develop cancer, particularly when the condition is monitored appropriately.

2. Causes & Risk Factors

The main cause of Barrett’s oesophagus is chronic gastro-oesophageal reflux disease (GORD). Repeated exposure of the oesophagus to stomach acid leads to changes in the lining.

Risk factors include long-standing or poorly controlled reflux symptoms, male sex, age over 50, central obesity, smoking, and a family history of Barrett’s oesophagus or oesophageal cancer.

3. Symptoms & How It May Present

Barrett’s oesophagus does not usually cause symptoms beyond those of reflux.

People may experience heartburn, regurgitation, chest discomfort, or difficulty swallowing related to GORD. Alarm symptoms such as progressive difficulty swallowing, weight loss, or bleeding require urgent assessment.

4. How Is It Diagnosed?

Barrett’s oesophagus is diagnosed during gastroscopy. The lining of the oesophagus appears abnormal and biopsies are taken to confirm the diagnosis.

Biopsies also assess for dysplasia, which refers to precancerous changes. The presence and grade of dysplasia determine surveillance intervals and treatment recommendations.

5. Treatment & Management Options

Management focuses on controlling acid reflux and monitoring the oesophagus for precancerous change.

This usually involves acid-suppressing medication, lifestyle modification, and regular surveillance gastroscopy. If dysplasia is detected, endoscopic treatments such as ablation or endoscopic resection may be recommended to reduce the risk of progression to cancer.

6. Living With / Managing Barrett’s Oesophagus

Most people with Barrett’s oesophagus live normal lives with appropriate treatment and surveillance.

Adhering to reflux management strategies, maintaining a healthy weight, and attending recommended follow-up gastroscopies are key to long-term management.

7. Prevention & Risk Reduction

Effective control of reflux symptoms reduces inflammation and may lower the risk of progression.

Avoiding smoking, limiting alcohol intake, weight management, and early investigation of persistent reflux symptoms help reduce risk.

8. When to Seek Medical Advice

You should seek medical advice if you have long-standing reflux symptoms, particularly if they are worsening or not responding to treatment.

Urgent review is required for difficulty swallowing, unintentional weight loss, vomiting blood, or black stools.