Medics from University Hospitals Coventry and Warwickshire (UHCW) NHS Trust have conducted research which could transform worldwide thinking about treatments and diagnosis for a common condition which affects thousands of patients.
The oesophagus or food pipe (gullet) is part of the digestive system.It is the tube that carries food from your mouth to your stomach. Barrett’s Oesophagus (also known as BE) and low-grade dysplasia affects approximately 2% of the adult population, particularly those with heartburn, as acid reflux from the stomach can, over time, damage the lining of the oesophagus and lead to BE. BEis seen in people undergoing endoscopy to determine the cause of their digestive problems.Barrett’s oesophagus can sometimes lead to cancer.
The team of researchers from UHCW NHS Trust, Warwick Medical School and Coventry University’s Centre for Technology Enabled Health Research found that invasive procedures are often not the best option to treat and diagnose patients suffering from Barrett’s Oesophagus.
Publishing their findings in the American Journal of Gastroenterology, the researchers looked at a wide range of studies about this condition.
Patients are currently commonly offered surgery for pre-cancerous changes in BE. However, the researchers found that in most cases, medical therapies and continuous monitoring are more effective to identify and prevent cancer for patients than surgery.
Where patients had a more advanced form of the condition, however, the team found that endoscopic resection surgery was the best option.
The team also recommended that men over 60 who had suffered gastro-oesophageal reflux disease (GORD) for ten years or over should be screened for Barrett’s Oesophagus.
The researchers have developed a new definition of BEto standardise diagnosis of the condition for clinicians in the USA and Europe. The team has also proposed a clear plan for treating patients depending on how their condition develops.
The world-leading study is believed to be one of the largest reviews of this kind in internal medicine. The team reviewed 20,300 papers by over 100 world experts.
Professor Janusz Jankowski, Professor of Acute Medicine at Warwick Medical School and UHCW NHS Trust, said:
“This paper could have huge implications for the thousands of patients diagnosed with Barrett’s Oesophagus.
“We hope that our findings will transform care for patients, and also help to identify patients at risk of developing cancer at the earliest possible opportunity.”
Professor Cathy Bennett, Professor in Systematic Reviews, at Coventry University, said:
“We created a unique opportunity for doctors and scientists from around the world to work together. We used a specially designed web-based platform to interact, discuss and summarise the vast amount of medical evidence available for the management of this condition. As a result of our work, healthcare professionals from all parts of the world will be able to access these new key recommendations”
The group now plans to look at genetic markers for BE patients, to determine the risk of patients going on to develop cancer.
The full paper, ‘BOB CAT, a Large-scale Review and Delphi Consensus for Management of Barrett’s Esophagus with No Dysplasia, Indefinite for, or Low Grade Dysplasia’, is available here: http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg201555a.html
University Hospitals Coventry and Warwickshire NHS Trust (UHCW) is one of the largest acute teaching Trusts in the UK, comprising University Hospital in Coventry and the Hospital of St Cross in Rugby.
Barrett’s Oesophagus is a common condition affecting thedigestive system, which is commonly linked to long-term gastro-oesophageal reflux disease (GORD).
The average age at diagnosis is 62, and it is a pre-cancerous condition, meaning that a small number of patients go on to develop oesophageal cancer.
For more information about potential complications of GORD, visit: http://www.nhs.uk/Conditions/Gastroesophageal-reflux-disease/Pages/Complications.aspx
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