Awareness of the risk factors and of who is at high risk can guide appropriate referral for specialist input and potentially surveillance – for example, Barrett’s oesophagus, achalasia, and genetic predisposition.

Careful monitoring of Barrett’s oesophagus may help detect cancer early, and early treatment may lead to better outcomes. Surveillance should be conducted by specialists with expertise in endoscopy and in managing Barrett’s oesophagus. Patient monitoring may include regular (as per clinical guidelines) upper endoscopies and tissue biopsies. The frequency of surveillance is based on the presence or absence of dysplasia. Refer to Cancer Council Australia’s guidelines.

Reflux symptoms in patients with Barrett’s oesophagus should be adequately treated (medically or surgically). Any change in symptoms should be reported early and investigated.

If there is high-grade dysplasia in Barrett’s oesophagus, subsequent treatment is usually recommended. Patients with high-grade dysplasia should be discussed in an MDM. After such discussion, treatment might include endoscopic therapies or surgery.