SIGNIFICANCE OF SHORT-SEGMENT BARRETTS-ESOPHAGUS

Barrett's esophagus can progress to dysplasia and adenocarcinoma. Alth ough the incidence of adenocarcinoma of the gastroesophageal junction has increased suddenly in the United States and Europe, we do not know how much of this increase is related to Barrett's esophagus. Interest in mucosal cell abnormalities at the gastroesophageal junction has le d researchers to re-examine short-segment Barrett's esophagus. In this recently described condition, specialized columnar epithelium is foun d in the distal 2 to 3 cm of the esophagus, yet it is not clear how it relates to conventional long-segment Barrett's esophagus, in which th e metaplastic epithelium extends higher than 2 to 3 cm above the squam ocolumnar junction. The reported prevalence of short-segment Barrett's esophagus found on diagnostic endoscopy varies from 8% to 32%. This w ide variation would be lessened by standardized location of biopsy spe cimens and of endoscopic and histologic staining techniques. Based on the information available, it is apparent that the age range and sex r atios are similar. Although reflux symptoms may be more common in shor t-segment Barrett's esophagous, disturbances in esophageal motility ar e less severe and there is less reflux as measured by continuous pH mo nitoring. Furthermore, recognized complications of Barrett's esophagus , such as ulceration, stricture, high-grade dysplasia, and adenocarcin oma, appear to be uncommon in short-segment Barrett's esophagus.