Aggressive acid control: Minimizing progression of Barrett's esophagus

Barrett's esophagus (BE) is a change in the cellular structure of the lower esophagus believed by many to be caused by frequent acid exposure. The con dition is troublesome because of a tendency toward cell proliferation, dysp lastic transformation, and cancerous changes within the lesions. It is spec ulated that the pronounced increase in esophageal adenocarcinoma during the past 25 years may be attributable to acid reflux and associated BE. Strict acid control may cause lesion regression in these patients. However, pH mo nitoring to confirm adequate acid control is essential, and more than 1 dru g may be needed to achieve adequate acid control and manage many patients, More research is needed to determine whether aggressive acid control reduce s the dysplasia and cancer risk associated with BE.