Skip to main contentLast updated: 07-Nov-2026
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Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Food Pipe Cancer Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
Dysplasia means the cells lining the food pipe look abnormal under the microscope. It is graded as none, low or high.
Dysplasia is not cancer, but the higher the grade, the closer the cells are to it. The grade decides how often you are scanned and what is done.
Ask for a second pathologist to confirm any dysplasia before a decision. Keep taking your acid tablet every day.
What Barrett’s is, why it happens and how it is treated are explained on our Barrett’s oesophagus page. This post covers one question: what the grades in your biopsy report mean.
The biopsy checks two things: whether the lining is truly Barrett’s, and whether any cells in it have become abnormal.
Long-standing acid reflux can change the lining of the lower food pipe. The normal pink lining is replaced by a gut-type lining, and your scope report may describe salmon-coloured patches. Only a biopsy confirms it.
The endoscopist first looks closely for any raised spot, ulcer or uneven patch, and takes biopsies from it separately. Then small pieces are taken from all four sides, at regular steps along the whole Barrett’s length. This is why several samples are sent, not one.
Dysplasia is graded under the microscope as none, indefinite, low-grade or high-grade. Each step means the cells look further from normal.
| Report says | What it means | Usual next step |
|---|---|---|
| Intestinal metaplasia, no dysplasia | Barrett’s lining, cells look regular | Daily acid tablet, scope at set intervals |
| Indefinite for dysplasia | Pathologist cannot tell if changes are from inflammation | Treat acid fully, repeat scope in a few months |
| Low-grade dysplasia | Mildly abnormal cells | Second pathologist review, then ablation or close scopes |
| High-grade dysplasia | Strongly abnormal cells, just short of cancer | Endoscopic treatment is usually advised |
| Cancer cells seen | Early cancer in the lining or deeper | Staging, then removal by scope or surgery |
Read the table as a guide. Your own report, the length of the Barrett’s segment and your general health shape the advice.
Two pathologists can read the same slide differently, most of all for low-grade changes. A second expert opinion makes the grade more reliable.
Inflamed, acid-damaged cells can look like dysplasia. Because treatment depends on the grade, we ask for the slides to be reviewed by a pathologist who sees many food pipe biopsies. We can arrange this for you.
No dysplasia needs watching. Low-grade needs a confirmed report and a choice between ablation and close scopes. High-grade usually needs treatment through the scope.
Scope treatment is done by an endoscopy specialist. We plan it with you, and Dr Harsh Shah operates if surgery becomes necessary.
The gap depends on the grade and the length of Barrett’s. Normal cells in a short segment need the longest gap, and dysplasia needs the shortest.
These gaps are a general pattern. Always follow the schedule your own report gives, and tell us if swallowing becomes hard or you lose weight in between.
Keep the biopsy report, the slides and the scope report together. Bring all three, so your surgeon can judge the grade and the next step.
If your report says dysplasia, you do not need to panic. The cells are being watched or treated before they turn into cancer, which is the whole purpose of surveillance. Do not wait or skip a scope because you feel well. Barrett’s seldom causes any symptom of its own.
No. Dysplasia means the cells look abnormal, but they have not yet become cancer. It is a warning stage that we watch or treat. The higher the grade, the closer the cells are to cancer.
It carries a higher risk than Barrett's without dysplasia, but it is not cancer. First we confirm the grade with a second pathologist. Then we choose between ablation and scopes about every six months.
Sometimes inflammation makes cells look abnormal, and a repeat biopsy after good acid control is normal. True dysplasia does not usually settle on its own, so it is watched or treated.
Barrett's can be patchy, and abnormal cells can hide in one small area. Samples from all four sides at steady steps along the segment give a fairer picture than a single piece.
Yes. Acid control protects the lining, so most people with Barrett's take an acid-reducing tablet daily. Do not stop it without asking the doctor who prescribed it.
Ablation and removal of raised patches through the scope are done by an endoscopy specialist. We plan the care with you and the endoscopist, and Dr Harsh Shah operates when surgery is needed.
Surgery is needed when cancer has gone deeper than scope treatment can reach, or when scope treatment is not possible. Reflux surgery is a separate option for some people with severe reflux.
For the full picture of Barrett’s and its treatment, start at the Barrett’s oesophagus page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Holding a Barrett's biopsy report and not sure what the grade means? Dr Harsh Shah reads the report with you, checks whether the biopsies were taken the right way, and plans the next step. Bring your endoscopy and slide reports to the visit. You can also call, or message us on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
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