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Barrett Esophagus

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A Mastery Approach to Complex Esophageal Diseases

Abstract

Barrett esophagus is a change of the normal squamous epithelium of the esophagus to specialized columnar metaplasia. Barrett esophagus is only important in that is associated with an increased risk of development of adenocarcinoma. It has a prevalence of 1.6% of the general population and an incidence of 9.9/1000 patients/year. Gastroesophageal reflux, male gender, Caucasian race, and obesity are the primary risk factors and duodeno-gastro-esophageal reflux is the primary causative agent. The pathogenesis of Barrett esophagus has not been fully elucidated, but it is believed that acid and bile leads to a cascade of genomic, transcriptomic and epigenetic changes leading to the progression of normal squamous epithelium to metaplasia, dysplasia and finally carcinoma. Screening for Barrett esophagus is controversial and should only be considered for high-risk populations. Endoscopic radiofrequency ablation is the preferred treatment modality for high-grade dysplasia and should be considered for low-grade dysplasia. Esophagectomy should only be considered for persistent high-graded dysplasia or high suspicion of invasive carcinoma.

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Authors and Affiliations

  1. Division of General Surgery, University of South Florida, Tampa, FL, USA

    Vic Velanovich M.D.

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  1. Vic Velanovich M.D.
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Correspondence to Vic Velanovich M.D. .

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  1. Nebraska Medical Center, University of Nebraska Medical Center, Omaha, Nebraska, USA

    Dmitry Oleynikov

  2. Harvard Medical School, West Roxbury, Massachusetts, USA

    P. Marco Fisichella

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Velanovich, V. (2018). Barrett Esophagus. In: Oleynikov, D., Fisichella, P. (eds) A Mastery Approach to Complex Esophageal Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-75795-7_11

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  • DOI: https://doi.org/10.1007/978-3-319-75795-7_11

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