Barrett's Oesophagus Screening — ESEGH MCQ

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ModerateGastroenterologyBarrett's Oesophagus ScreeningESEGH

A 52-year-old man with chronic gastro‑oesophageal reflux disease (GERD) and multiple risk factors (male sex, obesity, history of smoking) requests screening advice for Barrett’s oesophagus. Which of the following is most appropriate?

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Correct answer: A — Offer a one‑time upper endoscopy to look for Barrett’s oesophagus

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

This patient has chronic GERD and multiple recognised risk factors—male sex, obesity, smoking, and age over 50. BSG guidance supports considering one‑time endoscopic case finding in such patients, and ESGE similarly recommends targeted screening in this high‑risk group. A one‑time upper endoscopy is the diagnostic gold standard to detect Barrett’s oesophagus and obtain confirmatory histology. Routine screening is not advised (A), and CT chest or barium swallow (C, D) are inappropriate—they do not diagnose Barrett's. While optimising PPI therapy is appropriate for symptom control (E), it does not substitute for one‑time endoscopic assessment in this scenario.

Reference: BSG Guidelines on Barrett’s oesophagus diagnosis and management (2026 update); ESGE Diagnosis and management of Barrett’s oesophagus (2026); NICE CG184 GERD investigation (2019)