Hi,
Thanks for posting your query at DoctorSpring.com. I am Dr.R.K and I am pleased to assist you.
Yes, Barrett's is diagnosed with a biopsy from the Z line region only. When endoscopy shows suspicious lesions around the z line, it has to be biopsied.
Irregular Z line need not be always a Barrett's esophagus. Simple inflammation can also make it irregular.
Also it takes decades of reflux to cause Barrett's esophagus. Moreover not all cases of Barrett's esophagus lead to malignancy.
So there is no need to worry.
You can discuss with your doctor about the abnormal z line and ask him whether biopsy can be done to rule out Barrett's esophagus.
I hope that answers your questions. Please feel free to discuss further.
Regards,
Dr.R.K