Barrett’s Oesophagus
Barrett’s Oesophagus
Dr Rehan Haidry’s main interests are therapeutic and innovative endoscopic procedures. In particular he has expertise in disorders of the upper gastrointestinal tract, with a particular interest in Barrett’s Oesophagus.
A large proportion of his research efforts are focused on different aspects of the diagnosis and treatment of Barrett’s patients.
What is Barrett’s Oesophagus?
Barrett’s oesophagus is a ‘pre-cancerous’ condition; this means that some cells in the lining of the oesophagus (food pipe) have started to change and in a small number of patients these cells turn into oesophageal cancer.
The cells lining the food pipe are normally flat, but for a person with Barrett’s they change into an abnormal “column” shape (and in a small proportion will change further to pre-cancerous cells). Gastroenterologists call this ‘dysplasia’ and they can be classed as low grade or high grade, depending on how abnormal the cells look.
The majority of people with Barrett’s will not develop cancer, but 3-13% will. The risk of developing oesophageal cancer is highest for those with high grade dysplasia.
Barrett’s is more common in older people and slightly more common in men than women. The biggest risk factor is reflux issues such as Gastro-oesophageal reflux disease (GORD) or,Laryngopharyngeal reflux (LPR), as these create an acidic environment in the food pipe which is responsible for the cellular changes.
Diagnosing Barrett’s
Barrett’s symptoms include long term indigestion, heartburn and reflux issues, but these complaints are very common even in healthy people. There are also some people with Barrett’s who don’t display any symptoms at all. This means there is currently no national screening initiative in place for Barrett’s or oesophageal cancer in the UK.
If a person experiences indigestion/heartburn most days for over a month – or if symptoms are getting more uncomfortable or painful (such as pain when swallowing or regurgitating food), they should speak to their GP about seeing a gastroenterologist.
If Barrett’s is suspected, the doctor will perform an endoscopy. This involves passing a long flexible tube with a light and camera on the end, down the back of the nose to look at the food pipe cell lining up close. The doctor may take biopsies from suspected areas. Sometimes doctors discover Barrett’s when they are performing an endoscopy for something else.
Treating Barrett’s
Initially people with Barrett’s will be treated with medications to lower the amount of acid in the stomach, like Proton Pump Inhibitors or PPIs. These treatments aim to keep symptoms under control and reduce the risk of abnormal cells progressing to cancer.
In patients where cancerous cell changes have started, surgical treatments are available to remove the damaged areas of the food pipe. There are also endoscopic treatments which target the abnormal cells directly, like cryo-ablation and radio frequency ablation.
However in recent years a new procedure, which permanently prevents acid reflux, is available for people with reflux issues which could help those with Barrett’s to drastically reduce their risk of cancer.
Why TIF?
Transoral incisionless fundoplication (TIF) is an advanced endoscopy procedure to treat reflux issues. It is a permanent solution to prevent acid reflux. Dr Rehan Haidry is an experienced Consultant Gastroenterologist and interventional endoscopist, considered one of the country’s leading experts in reflux issues, and was the first doctor in Europe to offer TIF.
TIF is performed via endoscope and takes less than 30 minutes. During the procedure the bottom of the food pipe is pushed into the stomach and stitched into place creating a new ‘anti reflux valve’ for the patient that prevents stomach contents leaking up. TIF recovery is quick – most people are back home within 1 day and back at work within 4 days and it’s very safe, less than 0.5% patients will experience a serious problem.
Studies have shown that for up to five years after the TIF procedure, reflux symptoms are significantly reduced and around 80% of patients can stop taking daily heartburn drugs. The TIF procedure reduces the chronic acid reflux and reduces the harm to the cell lining (which may have turned cancerous over time).
22,000 TIF procedures have been carried out worldwide with minimal complications and a serious adverse event rate under 0.5%.
TIF is currently available at the Cleveland Clinic Hospital in London and is covered by most private insurers. To speak with Dr Haidry about if TIF is a suitable treatment option, book an appointment.
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org