Columnar lined oesophagus and intestinal metaplasia: current concepts

Barrett's oesophagus is a condition where the distal oesophagus is lined wi th columnar epithelium. For the diagnosis intestinal metaplasia has to be f ound and a minimal length of 3 cm is required for the columnar-lined segmen t. It is well known that patients with the traditional Barrett's oesophagus have a higher risk of developing adenocarcinomas in the metaplastic segmen t. The clinical significance of shorter metaplastic segments and intestinal metaplasia at the gastro-oesophageal junction is much less certain. Differ ent definitions are in use and the increasing number of studies dealing wit h these mucosal changes therefore may create confusion, In this article, th e current knowledge concerning epidemiology, pathophysiology, clinical asso ciations, diagnostic possibilities including endoscopy, pathology, measurem ent of differences in electrical potential, and treatment of columnar-lined oesophagus of any length and of intestinal metaplasia at the gastro-oesoph ageal junction is reviewed. Furthermore, the need for a consistent definiti on is emphasized, Eur J Gastroenterol Hepatol 11:793-800 (C) 1999 Lippincot t Williams & Wilkins.