We read with interest the British Society of Gastroenterology guidelines for the diagnosis and management of Barrett’s columnar-lined oesophagus¹ and the related commentary by Professor Playford (Gut 2006;55:442–3). One of the new recommendations in these guidelines relates to the diagnosis of Barrett’s oesophagus. The guidelines state that “the presence of areas of intestinal metaplasia, although often present, is not a requirement for diagnosis”. This is out of step with guidelines from the US, where intestinal metaplasia is required to establish a diagnosis of Barrett’s oesophagus.² The rationale for the British guidelines is that sampling errors at initial endoscopy may miss areas affected with …