MANAGEMENT OF BARRETTS-ESOPHAGUS

In Barrett's esophagus, the squamous lining of the lower esophagus is replaced by columnar epithelium. Barrett's esophagus is associated wit h gastroesophageal reflux and an increased risk of the development of esophageal cancer. Endoscopy shows red columnar epithelium in the lowe r esophagus, Biopsy is needed to confirm intestinal metaplasia, Some c ases progress from dysplasia to invasive adenocarcinoma, Medical or su rgical antireflux treatment controls symptoms and esophagitis, but Bar rett's esophagus remains. Patients are usually followed up by endoscop y for detection of dysplasia or early cancer, For patients with tow-gr ade dysplasia, follow-up is adequate; however, for those with high-gra de dysplasia, esophagectomy or experimental endoscopic mucosal ablatio n is advised.