How should I manage a patient with Barrett's oesophagus who develops dysplasia during surveillance endoscopy?

Management of Barrett's oesophagus with dysplasia detected during surveillance endoscopy:

• High-grade dysplasia: Offer endoscopic resection of visible oesophageal lesions as first-line treatment. After resection, offer endoscopic ablation of any residual Barrett's oesophagus to reduce recurrence risk.
• Low-grade dysplasia: Confirm diagnosis with biopsies taken at 2 separate endoscopies and reviewed by two gastrointestinal pathologists. Then offer radiofrequency ablation as treatment.
• Indefinite dysplasia: Consider endoscopic surveillance at 6-monthly intervals combined with optimisation of acid-suppressant medication.
• After any endoscopic treatment for dysplasia, offer endoscopic follow-up surveillance to monitor for recurrence or progression.

Throughout management, ensure the patient is fully informed and involved in decision-making, providing verbal and written information about diagnosis, treatment options, and support groups.