Management of Barrett's oesophagus in 2001 in Ireland.

BACKGROUND

Endoscopic surveillance of patients with Barrett's oesophagus is recommended to detect early carcinoma. The practice patterns of endoscopists since the publication of more recent management guidelines remain unknown.

METHODS

All endoscopists (n=68) in the Irish Medical Directory and their trainees were sent a postal questionnaire on Barrett's surveillance.

RESULTS

Fifty-five per cent (30/54) perform surveillance on all patients with Barrett's oesophagus and 38% on selected patients. In patients with no dysplasia, repeat endoscopy was more commonly practiced annually (28/54) than every two to three years (23/54). Surgeons were more likely to perform surveillance annually than gastroenterologists (75% vs 40%). Only 26% of endoscopists took four-quadrant biopsies every 2 cm. Intervention was recommended by a majority (28/54) of endoscopists in a patient with high grade dysplasia. A majority of respondents (47/54) would have surveillance if they were found to have Barrett's oesophagus.

CONCLUSION

Most endoscopists in Ireland do not adhere to recent guidelines in their management of Barrett's oesophagus. Surgical endoscopists perform surveillance more frequently than their medical colleagues.