Document Detail


Diagnosis and management of Barrett's esophagus for the endoscopist.
MedLine Citation:
PMID:  21180605     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In Barrett's esophagus, the stratified squamous epithelium lining the esophagus is replaced by specialized intestinal-type columnar epithelium. The prevalence of Barrett's esophagus has ranged from 0.9% to 4.5%. The rate of progression from Barrett's esophagus to esophageal adenocarcinoma is 0.5% per patient-year. Proton-pump inhibitors are the mainstay of symptom control in Barrett's patients. Nondysplastic Barrett's and Barrett's with low-grade dysplasia (LGD) are typically managed by periodic surveillance. Radiofrequency ablation is being evaluated as a modality for managing nondysplastic Barrett's and Barrett's with LGD. The options for the management of Barrett's patients with high-grade dysplasia (HGD) include endoscopic therapy, surgery, and intensive surveillance until biopsy reveals adenocarcinoma. Endoscopic therapy involves endoscopic mucosal resection (EMR) and ablation. More aggressive techniques such as endoscopic submucosal dissection and larger segment endoscopic mucosal resection are under study. In this review, we discuss the diagnosis and management of Barrett's esophagus. The recommendations from the major gastroenterologic societies and the current and investigational endoscopic modalities for the management of Barrett's esophagus with and without dysplasia are reviewed.
Authors:
Sagar S Garud; Steven Keilin; Qiang Cai; Field F Willingham
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Therapeutic advances in gastroenterology     Volume:  3     ISSN:  1756-2848     ISO Abbreviation:  Therap Adv Gastroenterol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-12-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101478893     Medline TA:  Therap Adv Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  227-38     Citation Subset:  -    
Affiliation:
Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA.
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