Skip to main content

Medical Evaluation of Barrett’s Esophagus

  • Chapter
  • First Online:
Benign Esophageal Disease

Abstract

The incidence of Barrett’s esophagus and esophageal cancer is on the rise, and the diagnosis, management, and surveillance of this disease process is evolving. Data from the last 15 years has demonstrated a benefit to early detection of BE as well as identified high risk populations. Technological advances in endoscopy allow for higher diagnostic and therapeutic yield and can be delivered in an increasingly safe and cost-effective fashion. Due to these advances, we are left with the question of who to enroll in surveillance programs and how to safely and effectively monitor them.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Corley DA, Mehtani K, Quesenberry C, et al. Impact of endoscopic surveillance on mortality from Barrett’s esophagus-associated esophageal adenocarcinomas. Gastroenterology. 2013;145:312–9.

    Article  Google Scholar 

  2. Garside R, Pitt M, Somerville M, et al. Surveillance of Barrett’s oesophagus: exploring the uncertainty through systematic review, expert workshop and economic modeling. Health Technol Assess. 2006;10:1–6.

    Article  CAS  Google Scholar 

  3. El-Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63:871–80.

    Article  Google Scholar 

  4. Shaheen NJ, Falk GW, Iyer PG, et al. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2016;111:30–50.

    Article  CAS  Google Scholar 

  5. Hayeck TJ, Kong CY, Spechler SJ, et al. The prevalence of Barrett’s esophagus in the US: estimates from a simulation model confirmed by SEER data. Dis Esophagus. 2010;23:451–7.

    Article  CAS  Google Scholar 

  6. Barret M, Prat F. Diagnosis and treatment of superficial esophageal cancer. Ann Gastroenterol. 2018;31:256–65.

    PubMed  PubMed Central  Google Scholar 

  7. Dresner SM, Griffin SM, Waymn J, et al. Human model of duodenogastro-oesophageal reflux in the development of Barrett’s metaplasia. Br J Surg. 2003;90:1120–8.

    Article  CAS  Google Scholar 

  8. Hirota WK, Loughney TM, Lazas DJ, et al. Specialized intestinal metaplasia, dysplasia, cancer of the esophagus and esophagogastric junction: prevalence and clinical data. Gastroenterology. 1999;116:277.

    Article  CAS  Google Scholar 

  9. Loughney T, Maydonovitch CL, Wong RK. Esophageal manometry and ambulatory 24-hour pH monitoring in patients with short and long segment Barrett’s esophagus. Am J Gastroenterol. 1998;93:916.

    Article  CAS  Google Scholar 

  10. Weston AP, Krmpotich PT, Cherian R, et al. Prospective long-term endoscopic and historical follow-up of short segment Barrett’s esophagus: comparison with traditional long segment Barrett’s esophagus. Am J Gastroenterol. 1997;92:407.

    CAS  PubMed  Google Scholar 

  11. Cook MB, Wild CP, Forman D. A systematic review and meta-analysis of the sex ratio for Barrett’s esophagus, erosive reflux disease, and nonerosive reflux disease. Am J Epidemiol. 2005;162:1050–61.

    Article  CAS  Google Scholar 

  12. Thrift AP, Kramer JR, Qureshi Z, et al. Age at onset of GERD symptoms predicts risk of Barrett’s esophagus. Am J Gastroenterol. 2013;108:915–22.

    Article  Google Scholar 

  13. Spechler SJ, Sharma P, Souza RF, et al. American Gastroenterological Association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:18.

    Article  Google Scholar 

  14. Rubenstein JH, Taylor JB. Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux. Aliment Pharmacol Ther. 2010;32:1222.

    Article  CAS  Google Scholar 

  15. Singh S, Garg SK, Singh PP, et al. Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett’s oesophagus: a systematic review and meta-analysis. Gut. 2014;63:1229–37.

    Article  Google Scholar 

  16. Kastelein F, Spaander MCW, Steyerberg EW, et al. Proton pump inhibitors reduce the risk of neoplastic progression in patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2013;11:382–8.

    Article  CAS  Google Scholar 

  17. Kastelein F, van Olphen SH, Steyerberg EW, et al. Impact of surveillance for Barrett’s oesohagus on tumor stage and survival of patients with neoplastic progression. Gut. 2016;65:548–54.

    Article  CAS  Google Scholar 

  18. Verbeek RE, Leenders M, ten Kate FJW, et al. Surveillance of Barrett’s esophagus and mortality from esophageal adenocarcinoma: a population-based cohort study. Am J Gastroenterol. 2014;109:1215–22.

    Article  Google Scholar 

  19. Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–31.

    Article  Google Scholar 

  20. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C&M criteria. Gastroenterology. 2006;131:1392–9.

    Article  Google Scholar 

  21. Gupta N, Gaddam S, Wani SB, et al. Longer inspection time is associated with increased detection of high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus. Gastrointest Endosc. 2012;76:531–8.

    Article  Google Scholar 

  22. di Pietro M, Canto MI, Fitzgerald RC. Clinical endoscopic management of early adenocarcinoma and squamous cell carcinoma of the esophagus (screening, diagnosis and therapy). Gastroenterology. 2018;154:421–36.

    Article  Google Scholar 

  23. Shariff MK, Varghese S, O’Donovan M, et al. Pilot randomized cross-over study comparing the efficacy of transnasal disposable endosheath to standard endoscopy to detect Barrett’s oesophagus. Endoscopy. 2016;48:110–6.

    PubMed  Google Scholar 

  24. Bhardwaj A, Hollenbeak CS, Pooran N, et al. A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett’s esophagus in patients with gastroesophageal reflux disease. Am J Gastroenterol. 2009;104:1533–9.

    Article  Google Scholar 

  25. Ross-Innes CS, Debiram-Beecham I, O’Donnovan M, et al. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett’s esophagus: a multi-center case-control study. PLoS Med. 2015;12:1–19.

    Article  Google Scholar 

  26. Offman J, Muldrew B, O’Donovan M, et al. Barrett’s oESophagus trial 3 (BEST3): study protocol for a randomized controlled trial comparing the Cytosponge-TFF3 test with usual care to facilitate the diagnosis of oesophageal pre-cancer in primary care patients with chronic acid reflux. BMC Cancer. 2018;18:784.

    Article  Google Scholar 

  27. Thorloor S, Bhattacharyya R, Tsagkournis O, et al. Acetic acid chromoendoscopy in Barrett’s esophagus surveillance is superior to the standardized random biopsy protocol: results from a large cohort study (with video). Gastrointest Endosc. 2014;80:417–24.

    Article  Google Scholar 

  28. Longcroft-Wheaton G, Duku M, Mead R, et al. Acetic acid spray is an effective tool for the endoscopic detection of neoplasia in patients with Barrett’s esophagus. Clin Gastroenterol Hepatol. 2010;8:843–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brian Hodgens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hodgens, B., Sakamoto, R., Mikami, D. (2021). Medical Evaluation of Barrett’s Esophagus. In: Zundel, N., Melvin, W.S., Patti, M.G., Camacho, D. (eds) Benign Esophageal Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-51489-1_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-51489-1_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-51488-4

  • Online ISBN: 978-3-030-51489-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics