{"id":20518,"date":"2024-08-21T09:12:43","date_gmt":"2024-08-21T08:12:43","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=20518"},"modified":"2026-03-26T14:11:19","modified_gmt":"2026-03-26T14:11:19","slug":"barretts-oesophagus","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/barretts-oesophagus\/","title":{"rendered":"Barrett\u2019s Oesophagus"},"content":{"rendered":"\n<p><strong>Requires Surveillance:<\/strong><\/p>\n\n\n\n<p>If patient has &lt;1cm of Barrett\u2019s oesophagus then&nbsp;no biopsies and no follow up required.\u200b<br><br>For those with histologically proven Barrett\u2019s oesophagus \u22651cm length,&nbsp;follow up interval depends on presence of dysplasia and length of Barrett\u2019s segment*<\/p>\n\n\n\n<p><em>* Follow-up by\u00a0oesophageal cell collection device ( \u201c<\/em><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" target=\"_blank\" rel=\"noreferrer noopener\">CapsuleSponge<\/a>\u201d), <em>\u00a0with endoscopy for selected cases.<\/em><\/p>\n\n\n\n<p><strong><em>Updated Oct 25 IA, CN, LP &amp; JB<\/em><\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Do not routinely offer OGD to those with GORD to diagnose Barrett\u2019s especially if age &lt;55<\/strong><\/p>\n\n\n\n<p><strong>Consider referral if long standing GORD especially if<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>family history of Barrett\u2019s or oesophageal adenocarcinoma<\/li>\n\n\n\n<li>Age 55 years or older<\/li>\n\n\n\n<li>long duration of symptoms<\/li>\n\n\n\n<li>worsening symptoms<\/li>\n\n\n\n<li>male<\/li>\n\n\n\n<li>previous hiatus hernia or oesophagitis<\/li>\n\n\n\n<li>obesity (BMI&gt;30)<\/li>\n\n\n\n<li>smoker<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Barrett\u2019s oesophagus Treatment<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Offer <strong>long term maintenance<\/strong> full dose PPI (eg omeprazole 20mg daily)<\/li>\n\n\n\n<li>Remain on full dose PPI (high dose may be necessary to control symptoms)\n<ul class=\"wp-block-list\">\n<li>High dose PPI (eg omeprazole 40mg daily)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Switch to another PPI at full or high dose if initial PPI fails to control symptoms<\/li>\n<\/ul>\n\n\n\n<p><strong>Follow up of Barrett\u2019s oesophagus (NHS Lothian)**<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If patient has &lt; 1cm of Barrett\u2019s oesophagus, then&nbsp;no biopsies and no follow up required<\/li>\n\n\n\n<li>After diagnosis follow up interval depends on:\n<ul class=\"wp-block-list\">\n<li>presence of dysplasia and length of Barrett\u2019s segment<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>If dysplasia is absent at index OGD, next follow-up should be by <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" target=\"_blank\" rel=\"noreferrer noopener\">Capsule Sponge<\/a>, repeated in 1 year<\/li>\n\n\n\n<li>If dysplasia is&nbsp;absent at 1year,&nbsp;subsequent follow up&nbsp;interval depends on length of Barrett\u2019s segment.<\/li>\n<\/ul>\n\n\n\n<p><strong>Barrett\u2019s &gt;3cm<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>OGD or <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" target=\"_blank\" rel=\"noreferrer noopener\">Capsule Sponge<\/a> every 3 years**<\/li>\n<\/ul>\n\n\n\n<p><strong>All others<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>OGD or <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" target=\"_blank\" rel=\"noreferrer noopener\">Capsule Sponge<\/a> every 5 years**<\/li>\n<\/ul>\n\n\n\n<p><em>**Follow-up currently by <\/em><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gastrointestinal\/capsulesponge\/\" target=\"_blank\" rel=\"noreferrer noopener\">Capsule Sponge<\/a>,<em>with endoscopy for selected cases<\/em><\/p>\n\n\n\n<p><strong>Further Information<\/strong><strong><\/strong><\/p>\n\n\n\n<p>The presence of low- or high-grade dysplasia will usually lead to MDT referral and\/or endoscopic therapy: this will be sorted in secondary care once histology results available<\/p>\n\n\n\n<p>If there is doubt about presence of dysplasia OGD is repeated after 6 months (usually with increased PPI dose)<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GI-Barretts-Oesophagus-nice.org_.uk_.html\" target=\"_blank\" rel=\"noreferrer noopener\">GI \u2013 Barrett\u2019s Oesophagus (nice.org.uk)<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/www.nice.org.uk\/guidance\/ng231\" target=\"_blank\" rel=\"noreferrer noopener\">www.nice.org.uk\/guidance\/ng231<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.esge.com\/assets\/downloads\/pdfs\/guidelines\/2023_a-2176-2440.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">ESGE Barrett\u2019s oesophagus guideline 2023 (endorsed by BSG)<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Requires Surveillance: If patient has &lt;1cm of Barrett&rsquo;s oesophagus then&nbsp;no biopsies and no follow up required.&#8203; For those with histologically proven Barrett&rsquo;s oesophagus &ge;1cm length,&nbsp;follow up interval depends on presence of dysplasia and length of Barrett&rsquo;s segment* * Follow-up by&nbsp;oesophageal cell collection device ( &ldquo;CapsuleSponge&rdquo;), &nbsp;with endoscopy for selected cases. Updated Oct 25 IA, CN,<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":3955,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1124],"class_list":["post-20518","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-barretts-oesophagus"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/gastrointestinal\/https-apps-nhslothian-scot-refhelp-barretts-oesophagus\/\" rel=\"tag\">Barrett's oesophagus<\/a>","rttpg_excerpt":"Requires Surveillance: If patient has &lt;1cm of Barrett&rsquo;s oesophagus then&nbsp;no biopsies and no follow up required.&#8203; For those with histologically proven Barrett&rsquo;s oesophagus &ge;1cm length,&nbsp;follow up interval depends on presence of dysplasia and length of Barrett&rsquo;s segment* * Follow-up by&nbsp;oesophageal cell collection device ( &ldquo;CapsuleSponge&rdquo;), &nbsp;with endoscopy for selected cases. Updated Oct 25 IA, CN,","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/20518","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=20518"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/20518\/revisions"}],"predecessor-version":[{"id":27415,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/20518\/revisions\/27415"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3955"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=20518"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=20518"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}