New treatment for common digestive condition Barrett's Oesophagus

New research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust could transform treatments and diagnosis for a common digestive condition which affects thousands of patients.

The oesophagus or food pipe (gullet) is part of the digestive system. It is the tube that carries food from your mouth to your stomach. Barrett's Oesophagus (also known as BE) and low-grade dysplasia affects approximately 2% of the adult population, particularly those with heartburn, as acid reflux from the stomach can, over time, damage the lining of the oesophagus and lead to BE. BE is seen in people undergoing endoscopy to determine the cause of their digestive problems. Barrett's Oesophagus can sometimes lead to cancer.

The team of researchers from Warwick Medical School, UHCW NHS Trust and Coventry University's Centre for Technology Enabled Health Research found that invasive procedures are often not the best option to treat and diagnose patients suffering from Barrett's Oesophagus.

Publishing their findings in the American Journal of Gastroenterology, the researchers looked at a wide range of studies about this condition.

Patients are currently commonly offered surgery for pre-cancerous changes in BE. However, the researchers found that in most cases, medical therapies and continuous monitoring are more effective to identify and prevent cancer for patients than surgery.

Where patients had a more advanced form of the condition, however, the team found that endoscopic resection surgery was the best option.

Barrett's Oesophagus

Barrett's Oesophagus is a condition in which the oesophagus changes, so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine. This lining is called intestinal metaplasia. Barrett’s Oesophagus is closely associated with Gastro-Oesophageal Reflux Disease (GORD), in which food and gastric liquids can enter the oesophagus from the stomach. It is presumed that the recurrent entry of these liquids into the oesophagus lead to the change of the oesophageal lining into that of intestinal Metaplasia.

While Barrett's Oesophagus may cause no symptoms itself, a small number of people with this condition develop a relatively rare but often deadly type of cancer of the oesophagus called Oesophageal Adenocarcinoma. This condition was described in the early 1950's by an Australian Surgeon Dr. Norman Rupert Barrett, who noticed that cells lining and extending from the lower oesophagus were secreting red mucus without causing inflammation. He believed these cells made up a tubular stomach in patient's who had a short oesophagus, however ten years later he discovered that the mucus secreting cells were an abnormality of normal cells, which now is known to lead to oesophageal cancer. Hence this condition is named in honour of Dr. Barrett.