Present medical management of Barrett's oesophagus

The management of Barrett's oesophagus should aim to treat symptoms, and pr event complications of reflux, Treatment of choice is a proton pump inhibit or: with the option of surgical treatment in younger patients, Uncertaintie s remain about the significance of short segment Barrett's oesophagus. Doub ts also remain about the benefit and cost-effectiveness of conventional sur veillance of Barrett's oesophagus; for patients with an annual cancer risk of 0.5% 5-yearly endoscopy and biopsies for patients without dysplasia repr esent the best strategy. Novel modalities such as photodynamic therapy have shown encouraging results for high grade dysplasia or early cancer for pat ients unsuitable for surgery. Finally, agents such as cyclooxygenase-2 inhi bitors hold promise for prevention of malignancy in Barrett's oesophagus.