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- due to chronic gastro-oesophageal reflux
- causes a specialized non-secretory columnar epithelium to grow cranially in previous site of squamous epithelium
- 2 cm or more of columnar epithelium needed to reach this diagnosis
- may develop high grade dysplasia
- 40 fold risk of developing esophageal carcinoma. 15% develop adenocarcinoma
- >2 cm involvement needs 2 yearly endoscopic surveillance
barium swallow
- wide patulous hiatal segment (associated hiatus hernia)
- dilated segment of esophagus above the hernia which is bell or tent shaped
- junction of two mucosal types is marked by a slightly contractile ring, here ulceration and secondary strictures occur
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