Guidelines

BSG 2013 Guidelines for the management of Barrett's Oesophagus

The BSG (British Society of Gastroenterologists) issued new guidelines in 2013 for the management of Barrett's Oesophagus, the short version (38 pages) of which (published in Gut October 2013) may be downloaded below. (File name: bsg_barretts_13)

It includes the following charts:

A management map for HGD may also be found on page 24 of the document.

The appendix included in the fuller (148 page) document, contains useful information for patients.

Appendix 2 shows endoscopic images around the z-line (page 7)

Histopathological images, from biopsied samples (page 8)

and information for patients (pages 9 and 10)

Revised British Society of Gastroenterology recommendation on the diagnosis and management of Barrett's Oesophagus with Low Grade Dysplasia - from the BSG Barrett's Guidelines working group published in Gut, April 2017.

Updated flow chart (shown above) for the management of dysplastic Barrett's oesophagus. A pathological finding of indefinite for dysplasia does not exclude the presence of dysplasia; therefore, a 6-month follow-up is warranted. Endoscopic follow-up in 6 months is recommended for LGD. If LGD is also found at follow-up endoscopy, even if not consecutive, provided that the diagnosis of dysplasia on two occasions is confirmed by two independent GI pathologists (ideally from a different institution), endoscopic ablation should be considered. A diagnosis of high-grade dysplasia (HGD) also needs to be confirmed by a second GI pathologist. Patients with dysplasia should be offered endoscopic therapy following discussion within MDT setting. LGD, low-grade dysplasia; HGD, high-grade dysplasia; MDT, multidisciplinary team; OGD, oesophagogastroduodenoscopy.