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barrett's%20esophagus
BARRETT'S ESOPHAGUS
Treatment Guideline Chart
Barrett's esophagus is defined as the endoscopic finding in the distal esophagus of proximal-appearing columnar-lined esophagus of at least 1-cm length that is confirmed by histology.
It is considered a premalignant metaplastic condition that usually involves the distal esophagus.
It is postulated that exposure of the esophageal epithelium to acid damages the lining resulting in chronic esophagitis and its healing involves metaplastic process.

Barrett's%20esophagus Signs and Symptoms

Introduction

  • Defined as the endoscopic finding in the distal esophagus of proximal-appearing columnar-lined esophagus of at least 1-cm length that is confirmed by histology 
  • Considered a premalignant metaplastic condition that usually involves the distal esophagus
    • It is postulated that exposure of the esophageal epithelium to acid damages the lining resulting in chronic esophagitis and its healing involves metaplastic process
  • The incidence of progressing to adenocarcinoma is approximately 0.27-0.59% of Barrett’s esophagus patients per year
    • Intestinal metaplasia is not required for diagnosis, though risk of progression to carcinoma is higher in its presence
  • Diagnosed by endoscopy and histological examination

Risk Factors

  • Chronic gastroesophageal reflux disease (GERD)
  • White or Hispanic race
  • Male
  • Advancing age (>50 years, reaching a plateau in the 60’s) - reported as a significant risk factor in various Asian studies
  • Hiatal hernia
  • Smoking
  • Central obesity (intra-abdominal body fat distribution)
  • Alcohol (as shown in an Asian study)
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