Diagnosis and management of Barrett's esophagus

Surg Clin North Am. 2012 Oct;92(5):1135-54. doi: 10.1016/j.suc.2012.07.009. Epub 2012 Aug 20.

Abstract

Barrett esophagus is characterized by the replacement of squamous mucosa in the esophagus by specialized intestinal metaplasia. Its clinical significance lies in it being the strongest risk factor for and known precursor for esophageal adenocarcinoma. Diagnosis requires endoscopic confirmation of columnar metaplasia in the distal esophagus and histologic confirmation of specialized intestinal metaplasia. Recommendations for the management of subjects diagnosed with Barrett esophagus include periodic endoscopic surveillance to detect the development of high-grade dysplasia or adenocarcinoma. Careful endoscopic evaluation with high-resolution endoscopy and endoscopic resection is recommended in the evaluation of subjects with high-grade dysplasia and early adenocarcinoma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ablation Techniques
  • Barrett Esophagus* / diagnosis
  • Barrett Esophagus* / etiology
  • Barrett Esophagus* / physiopathology
  • Barrett Esophagus* / therapy
  • Biomarkers / metabolism
  • Early Diagnosis
  • Esophagoscopy / methods
  • Fundoplication
  • Humans
  • Population Surveillance
  • Proton Pump Inhibitors / therapeutic use
  • Risk Assessment

Substances

  • Biomarkers
  • Proton Pump Inhibitors