Barrett's oesophagus with low-grade dysplasia — ESEGH MCQ

Correct answer: B — Refer to a Barrett expert centre for therapy

The best answer is “Refer to a Barrett expert centre for therapy”. Persistence on two examinations plus expert confirmation identifies the group for whom ablation-based eradication is recommended. “Discharge from Barrett surveillance follow-up” is less appropriate because confirmed LGD has a material progression risk “Repeat endoscopy in 10 years” is less appropriate because this is far too delayed for dysplasia “Immediate oesophagectomy in every patient” is less appropriate because endoscopic therapy is organ-preserving first-line management for suitable superficial disease “Oral prednisolone” is less appropriate because corticosteroids do not eradicate dysplastic Barrett epithelium

Reference: NICE NG231 Barrett oesophagus: https://www.nice.org.uk/guidance/ng231