Epidemiology and pathophysiology of Barrett's esophagus

The pathophysiology of Barrett's esophagus appears to be a sequential proce ss; the squamous epithelium of the esophagus is replaced by multipotent und ifferentiated cells: secondary to cellular damage in the course of gastroes ophageal reflux disease these undifferentiated cells further differentiate under the ongoing influence of mucosal damage, thus forming the typical mor phology of Barrett mucosa. While the prevalence of gastroesophageal reflux disease amounts to 10 % to 30 %, the prevalence of Barrett's esophagus is e stimated to be 1 % in the general population. The epidemiologic data of Bar rett's esophagus gain special attention with regard to the fact that the sp ecialized columnar epithelium with intestinal metaplasia represents the onl y recognized risk factor for the development of adenocarcinoma in the esoph agus. Currently it is estimated that the risk of the development of an aden ocarcinoma on the basis of Barrett's esophagus is about 30-50 fold higher t han that in the general population.