[Barrett esophagus]

Barrett's oesophagus is a complication of chronic gastrooesophageal reflux disease and occurs in eight percent of patients with reflux symptoms. The diagnosis is made by endoscopy with biopsy. Dysplasia and early adenocarcinoma may involve only very small irregular areas of the oesophageal mucosal surface. Biopsies should therefore be taken from each quadrant at 1-2 cm intervals. The prevalence of dysplasia is about five to 16 percent, while the prevalence rate of oesophageal adenocarcinoma ranges from nought to ten percent and the incidence is one case per 87 patients years. No consensus concerning the treatment strategy for patients with metaplasia and low grade dysplasia has been achieved, because there is no conclusive proof as yet that screening programmes reduce the mortality from adenocarcinoma. Patients with high grade dysplasia should be controlled with endoscopy and biopsies every sixth month. Flow cytometry seems to be able to identify a subset of patients with an increased risk of oesophageal adenocarcinoma.