Barrett's Oesophagus

The word oesophagus reminds me of the muppet Snuffleupaguss.

Moving on.

Barrett's Oesophagus
aka Columnar-Lined Oseophagus aka CLO

Does exactly what it says on the tin. No, it doesn't sell shoes, silly, not that bit of the tin - the CLO bit.
Barrett's is the occurrence of metaplasia in the distal oesophagus, where its squamous epithelium is replaced by columnar epithelium, of the gastric/intestinal type.

Aetiology
It is a complication of chronic oesophagitis.and occurs in 10% of people with symptomatic GORD, and 40% of those with peptic oesophageal strictures.

Ix
Endoscopy!
 - abnormal red mucosa lies as islands or circumferential bands between the normal white squamous epithelium of the oesophagus and the normal gastric mucosa.
http://library.med.utah.edu/WebPath/GIHTML/GI416.html
.
Micro:
Sudden transition from squamous epithelium to columnar epithelium, proximal to GOJ.
Considered 'typical' Barrett's mucosa if it includes intestinal metaplasia i.e. goblet cells.
http://library.med.utah.edu/WebPath/GIHTML/GI171.html

Complications
x30/40 increased risk of adenocarcinoma of the oesophagus.
This can't be taken lightly, therefore CLO patients are required to undergo frequent endoscopy and biopsies.
The aim is to diagnose and treat and dysplastic changes when they occur, and treat any invasive disease ASAP.

Adenocarcinoma identified on biopsy
http://library.med.utah.edu/WebPath/GIHTML/GI406.html