Barrett esophagus

Barrett esophagus 

Updated: 02/14/2022

© Jun Wang, MD, PhD

General features
  • Intestinal metaplasia of distal squamous mucosa
  • Incidence higher in whites, males, obese (especially with central adiposity)
  • May regress after treatment
  • Major risk factor for esophageal adenocarcinoma
Etiology
  • Chronic injury, i.e. chronic gastroesophageal reflux 
Clinical presentations
  • Long history of heartburn and other reflux symptoms
  • More massive reflux with more numerous and longer episodes than most reflux patients
Pathological features
Low grade: Minimal glandular architectural distortion, elongated hyperchromic nuclei in deep glands and surface epithelium
High grade: Distorted glandular architecture, markedly atypical nuclei
Diagnosis
  • Endoscopic examination with biopsy
Treatment
  • No dysplasia: follow up
  • Low grade dysplasia: endoscopic eradication, or endoscopic surveillance annually
  • High grade dysplasia:endoscopic therapy, endoscopic surveillance every 3 months for first year, every 6 months for second year, and annually after.


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