Barrett’s oesophagus is a condition where the lining of the lower oesophagus (the tube that carries food from your mouth to your stomach) changes. Normally, the oesophagus is lined with squamous cells, but in Barrett’s, this lining is replaced by cells more similar to those found in the intestines.
This change usually happens as a result of long-term irritation from acid reflux, also known as gastro-oesophageal reflux disease (GORD). While Barrett’s itself doesn’t cause symptoms, most people with the condition do experience reflux symptoms such as heartburn or indigestion.
Barrett’s oesophagus is important because it slightly increases the risk of developing oesophageal cancer. The overall risk is still low—about 95% of people with Barrett’s will never develop cancer—but monitoring is recommended to help catch any changes early.
Barrett’s oesophagus is diagnosed during a procedure called a gastroscopy (or endoscopy). During this test, your doctor uses a flexible camera to examine your oesophagus and take small tissue samples (biopsies) to check for the presence of Barrett’s cells.
Your doctor might suspect Barrett’s based on how the oesophagus looks during the procedure, but a biopsy is needed to confirm the diagnosis under a microscope.
There’s no national screening program for Barrett’s, but many gastroenterologists recommend a gastroscopy for people over 40 who have had reflux symptoms for several years.
Treatment for Barrett’s oesophagus typically focuses on:
Managing acid reflux – Medications that reduce stomach acid, such as proton pump inhibitors (PPIs), are commonly used. Even if you don’t feel reflux symptoms, these medications may help lower the risk of cancer by reducing inflammation in the oesophagus.
Regular monitoring (surveillance) – If you have Barrett’s, your doctor will likely recommend periodic gastroscopies to keep an eye on the oesophagus. How often you need these checks depends on your previous biopsy results and overall risk.
Targeted treatment – In some cases, where biopsy results show a higher risk of cancer, your doctor may recommend removing or treating the abnormal cells. One common method is radiofrequency ablation (RFA), which uses heat to gently remove the affected lining. Other treatments are also being studied in clinical trials.
Barrett’s oesophagus can sound worrying, but with routine monitoring and effective treatment, most people manage the condition well. If you’ve had long-term reflux or are concerned about your risk, speak with your gastroenterologist. They can help guide you through the right steps for diagnosis, treatment, and ongoing care.
For more resources, visit the Gastroenterological Society of Australia.