Barrett’s Esophagus: Diagnosis and Management

Abstract

Barrett’s esophagus is a complication caused by Gastro Esophageal Reflux Disease (GERD). It is a premalignant condition with an increased risk of developing esophageal adenocarcinoma.  The carcinogenic sequence may progress through several steps, from normal esophageal mucosa through Barrett’s esophagus (BE) to esophageal adenocarcinoma (EAC). A recent advent of functional esophageal testing (particularly multichannel intraluminal impedance and pH monitoring) has helped to improve our knowledge about GERD pathophysiology, including its complications and its neoplastic progression. Over the last few decades, the incidence of EAC has continued to rise in Western populations. Thus, major efforts in clinical and research practice are focused on new methods for optimal risk assessment that can stratify BE patients at low or high risk of developing EAC. Furthermore, the area of BE therapeutic management is rapidly evolving. Endoscopic eradication therapies have been shown to be effective, and new therapeutic options for BE and EAC have emerged. The aim of the present review article is to highlight the pathophysiology, diagnosis and the current progress of BE therapy.Moreover, we discuss the new mucosal ablative techniques that can be used in the esophagus have emerged over the past two decades.