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Barrett’s esophagus: Incidence, etiology, pathophysiology, prevention and treatment

Authors Nir Modiano, Lauren B Gerson

Published 15 January 2008 Volume 2007:3(6) Pages 1035—1045

Nir Modiano1, Lauren B Gerson2

1Department of Internal Medicine, 2Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California

Abstract: Barrett’s esophagus is a metaplastic alteration of the normal esophageal epithelium that is detected on endoscopic examination and pathologically confirmed by the presence of intestinal metaplasia on biopsy. Its major significance is as a predisposing factor for esophageal adenocarcinoma, which carries a high mortality rate and a rapidly growing incidence in the United States. Detection of Barrett’s esophagus allows for endoscopic surveillance in order to detect the potential development of dysplasia and early cancer before symptoms develop, and thereby significantly increases treatment options and may lower mortality from esophageal adenocarcinoma. Much current work in the field is aimed at reducing the risk of progression from Barrett’s esophagus to cancer, and in the identification of biomarkers that may predict progression towards cancer. Barrett’s esophagus is present in 10%–20% of patients with gastroesophageal reflux disease (GERD) and has also been detected in patients who deny classic GERD symptoms and are undergoing endoscopy for other indications. We used an evidence-based approach to describe treatment options for patients with Barrett’s esophagus.

Keywords: Barrett’s esophagus, esophageal adenocarcinoma, evidence-based approach, endoscopic surveillance

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