Recent developments in pathogenesis, diagnosis and therapy of Barrett's esophagus

World J Gastroenterol. 2015 Jun 7;21(21):6479-90. doi: 10.3748/wjg.v21.i21.6479.

Abstract

The burden of illness from esophageal adenocarcinoma continues to rise in the Western world, and overall prognosis is poor. Given that Barrett's esophagus (BE), a metaplastic change in the esophageal lining is a known cancer precursor, an opportunity to decrease disease development by screening and surveillance might exist. This review examines recent updates in the pathogenesis of BE and comprehensively discusses known risk factors. Diagnostic definitions and challenges are outlined, coupled with an in-depth review of management. Current challenges and potential solutions related to screening and surveillance are discussed. The effectiveness of currently available endoscopic treatment techniques, particularly with regards to recurrence following successful endotherapy and potential chemopreventative agents are also highlighted. The field of BE is rapidly evolving and improved understanding of pathophysiology, combined with emerging methods for screening and surveillance offer hope for future disease burden reduction.

Keywords: Barrett’s esophagus; Esophageal cancer; Esophagus; Gastroesophageal reflux disease.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / prevention & control*
  • Anticarcinogenic Agents / therapeutic use
  • Barrett Esophagus / diagnosis*
  • Barrett Esophagus / epidemiology
  • Barrett Esophagus / surgery*
  • Biopsy
  • Disease Progression
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / prevention & control*
  • Esophagectomy / methods*
  • Esophagoscopy / methods*
  • Humans
  • Precancerous Conditions / diagnosis*
  • Precancerous Conditions / epidemiology
  • Precancerous Conditions / surgery*
  • Predictive Value of Tests
  • Recurrence
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticarcinogenic Agents

Supplementary concepts

  • Adenocarcinoma Of Esophagus