Risk factors for Barrett’s include a long history of reflux, central obesity, history of smoking, having a hiatal hernia and a positive family history for Barrett’s. However, although Barrett’s is a precursor to oesophageal cancer, majority of patients with Barrett’s fortunately do not progress to cancer. Currently, there is no reliable method to differentiate those who will vs who will not progress to cancer therefore endoscopic surveillance is recommended for all. The frequency for surveillance is dependent on severity (or risk of cancer) of Barrett’s.

Management of Barrett’s is primarily focused on keeping the Barrett’s stable or inducing minor regression with reflux control through modifying dietary/lifestyle risk factors and use of medications such as Somac, Nexium or Losec. If high risk Barrett’s is identified through an index endoscopy or through surveillance endoscopy, then ablation will be necessary to prevent development of Oesophageal cancer. Ablative methods including endoscopic mucosal resection (Cutting) or HALO radiofrequency ablation (burning). The optimal method of treatment is dependent on the individual characteristics of the Barrett’s in question. Ablating Barrett’s is often a complex procedure which requires in-depth discussion.