# Barrett's oesophagus - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under "Long-term management of patients with healed esophagitis to prevent relapse". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. · Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under "Gastroesophageal reflux disease, including reflux esophagitis". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose. · Khieu M, Goosenberg E. Barrett Esophagus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- (chapter last updated 2025 May 26). PMID: 28613697. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under "Long-term management of patients with healed esophagitis to prevent relapse". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. - Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under "Gastroesophageal reflux disease, including reflux esophagitis". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose. ## Treatment metadata - Omeprazole — oral.solid - Esomeprazole — oral.solid ## Complete treatment card ```text BARRETT'S OESOPHAGUS Sources: Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under "Long-term management of patients with healed esophagitis to prevent relapse". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. · Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under "Gastroesophageal reflux disease, including reflux esophagitis". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose. · Khieu M, Goosenberg E. Barrett Esophagus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan- (chapter last updated 2025 May 26). PMID: 28613697. Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Heartburn behind the breastbone, worse after meals [heartburn] - Acid regurgitation [regurgitation] - Less often: difficulty swallowing, hoarseness, sore throat, chest pain or a chronic cough [chest pain · cough · difficulty swallowing · hoarseness · sore throat] - Black tarry stool or weight loss may occur [weight loss] - Some have no symptoms at all - Usually a long-standing history of reflux [heartburn] SIGNS - what you find (1) - Physical examination is typically unremarkable TESTS (12) - Endoscopy with forceps biopsy is the gold-standard test - Diagnosis needs at least 1 cm of salmon-coloured columnar lining above the gastro-oesophageal junction - Biopsy must confirm intestinal metaplasia with goblet cells - British and Japanese groups do not require goblet cells, columnar metaplasia alone suffices - At least eight biopsies, two per quadrant every 2 cm, for shorter segments - Seattle protocol, used beyond 4 cm, samples all four quadrants at 2 cm steps, tightening to 1 cm where dysplasia is suspected - Dysplasia is often flat and invisible at endoscopy - A nodule or an ulcer seen at endoscopy raises concern for dysplasia - Chromoendoscopy with high-definition white light improves pickup of dysplasia and cancer - p53 staining can reveal dysplasia missed on routine stains and predicts progression - Alternatives to sedated endoscopy: transnasal scope, or a swallowed capsule sponge with a biomarker - Screening targets chronic reflux with added risk: male, over 50, White, smoking, central obesity, family history IF NOT THIS - what else fits (8) - Gastric metaplasia of the oesophagus looks identical at endoscopy but carries no cancer risk - Acute gastritis - Chronic gastritis, with or without H pylori - Coronary artery atherosclerosis - Reflux oesophagitis - Oesophageal cancer - An oesophageal motility disorder - Gallstones Source StatPearls "Barrett Esophagus" - disease-level clinical article Status traced to the source above 1. OMEPRAZOLE [1st line] Adult 10-20 mg once daily, up to 40 mg once daily in refractory cases x 4-8 weeks - this is the formulary's course for reflux oesophagitis. The formulary gives no duration for Barrett's oesophagus; continuation beyond the initial course is a clinical decision. Peds The formulary gives no paediatric dose for Barrett's oesophagus. Its only paediatric omeprazole entry is severe ulcerating oesophagitis in children over 2 years: 0.7-1.4 mg/kg (the formulary does not state whether that is per dose or per day), to a maximum of 40 mg/day, for 4-12 weeks. Specialist decision; do not calculate from these figures. Source Egyptian National Drug Formulary - GIT medicines (git.pdf), Omeprazole monograph, PDF page index 90 (printed p80), under "Gastroesophageal reflux disease, including reflux esophagitis". The formulary carries no Barrett's oesophagus indication; this is its reflux-oesophagitis dose. Why Barrett's oesophagus results from chronic reflux; the formulary's GERD/reflux- oesophagitis dose is the standard PPI regimen used to control ongoing acid reflux while endoscopic surveillance continues. Caution Rule out gastric malignancy if alarm symptoms are present (weight loss, dysphagia, recurrent vomiting, haematemesis, melaena). The Egyptian formulary does not list Barrett's oesophagus as an omeprazole indication - the dose shown is its reflux-oesophagitis dose. Long-term PPI use (needed for Barrett's) carries small increased risks of B12/magnesium deficiency, fracture, and enteric infection with prolonged use - review periodically rather than continuing indefinitely without follow-up. Investigate red-flag symptoms (dysphagia, odynophagia, unintentional weight loss, GI bleeding, new iron-deficiency anaemia) rather than treating symptomatically alone. Barrett's oesophagus needs endoscopic surveillance on a schedule set by the endoscopist/gastroenterologist in addition to acid suppression - a PPI alone does not remove the cancer risk. Egypt OMEPAK 10 MG 14 CAPS. SEDICO 14.40 EGP (1.03/unit) OMEGASTAZOLE 20MG 14 CAPS. RIVA PHARMA S... 18.00 EGP (1.29/unit) RISEK 10 MG 14 CAPS. JULPHAR 19.20 EGP (1.37/unit) OMEZ 10MG 14 CAPS. PHAROPHARMA 40.00 EGP (2.86/unit) OMEPAK 20 MG 14 CAPS. SEDICO 50.00 EGP (3.57/unit) NAPIZOLE 40MG 14 CAPS. GLOBAL NAPI P... 62.00 EGP (4.43/unit) OMEZ 40MG 20 CAPS. PHAROPHARMA 130.00 EGP (6.50/unit) PEPZOL 40MG 7 CAPS. HIKMA PHARMA 51.00 EGP (7.29/unit) 2. ESOMEPRAZOLE [2nd line] Adult 20 mg by mouth once daily, continued long term. - Long-term/ongoing. The formulary sets no end point for relapse prevention and gives no Barrett's-specific duration. Peds The formulary gives no paediatric dose for Barrett's oesophagus. Its paediatric esomeprazole entries cover erosive reflux oesophagitis only, in children of 1 to 11 years: from 10 kg up to 20 kg it is 10 mg once daily, and at 20 kg and over either 10 mg or 20 mg; both for 8 weeks. It adds that anything above 1 mg/kg/day is unstudied - a ceiling, not a dose to multiply. Paediatric use is a specialist decision. Source Egyptian National Drug Formulary - GIT medicines (git.pdf), Esomeprazole monograph, PDF page index 74 (printed p64), under "Long-term management of patients with healed esophagitis to prevent relapse". The formulary carries no Barrett's oesophagus indication; this is its maintenance dose for healed oesophagitis. Why Alternative PPI; the formulary explicitly includes a long-term maintenance line ('to prevent relapse') that matches the chronic nature of Barrett's oesophagus particularly well. Caution The Egyptian formulary does not list Barrett's oesophagus as an esomeprazole indication - the dose shown is its maintenance dose for healed reflux oesophagitis. Long-term PPI use carries small increased risks of B12/magnesium deficiency, fracture, and enteric infection - review periodically. Alternative PPI to omeprazole - choose one, not both together. Investigate red-flag symptoms (dysphagia, odynophagia, weight loss, GI bleeding, new iron-deficiency anaemia) rather than treating symptomatically alone; Barrett's still needs scheduled endoscopic surveillance. Egypt ESMOPROTON 20 MG 20 CAPS. WADI EL-NEEL ... 42.00 EGP (2.10/unit) ORGIXIUM 20 MG DR 21 CAPS. EGPI > ORIGIN... 49.50 EGP (2.36/unit) BIORAZO 20MG 14 CAPS. BIOPHARM EGYP... 42.00 EGP (3.00/unit) PROTOPAN 40 MG 21 CAPS. PHAROPHARMA 159.00 EGP (7.57/unit) NEXIMERICAN 40 MG 14 CAPS. MEDIZEN PHARM... 138.00 EGP (9.86/unit) ESOMEPRAZOLE-EVA 20MG 20 E.C. TABS. EVA PHARMA 82.00 EGP REFLUTINAL 40 MG 28 H.G. CAPS HIGH PERFORMA... 320.00 EGP NEXIUM 10 MG 28 SACHETS ASTRA ZENECA 364.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)