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The diagnosis of Barrett's oesophagus can only be made with a combination of an upper GI endoscopy and samples of cells taken at the time of the endoscopy, called biopsies.

Upper GI endoscopy - diagnostic

This is a common procedure involving the insertion of a thin tube with a camera on the end through the mouth into the oesophagus, stomach and first part of the small bowel called the duodenum. This test is important to look for a range of problems such as acid damage or an ulcer. It is a very routine procedure, but as with any test there are benefits and risks, even though the risks are very low. More information on this procedure, its benefits and risks are available here.

Barrett's oesophagus has a particular appearance on upper GI endoscopy. If the person performing the endoscopy thinks the appearances suggest Barrett's oesophagus, they will take small samples of tissue (called biopsies) which will then be sent to the laboratory to be looked at under a microscope in the next 2-4 weeks. This will then confirm whether or not Barrett's oesophagus is present.

Upper GI endoscopy - surveillance

Once somebody has been found to have Barrett's oesophagus, if they are suitable, they will then be booked for further upper GI endoscopies on a regular basis to monitor for further changes or the development of cancer. These may be carried out every 2 to 5 years, depending upon how much Barrett's they have on their endoscopy.

A surveillance endoscopy involves careful examination of the lining of the oesophagus for any lumps or nodules. Sometimes, different types of lighting technique or dyes may be used to help with this examination. It also involves taking multiple biopsies to check for changes in the cells, for example to 'pre-cancerous' or dysplastic cells. Depending upon how long the area of Barrett's oesophagus is, this examination can take longer than a normal diagnostic endoscopy. However, it is very important to have a careful look to make sure any subtle changes are detected.