Barrett's esophagus is the condition in which a metaplastic columnar epithelium that predisposes to cancer development replaces the stratified squamous epithelium that normally lines the distal esophagus . The metaplastic epithelium is acquired as a consequence of chronic gastroesophageal reflux disease (GERD).
The management of patients with Barrett's esophagus involves three major components:
- Treatment of the associated GERD
- Endoscopic surveillance to detect dysplasia
- Treatment of dysplasia
In addition, chemoprevention to reduce the rate of malignant transformation has also been evaluated.
These issues will be reviewed here. Many remain controversial with considerable disagreement among experts [2,3]. The pathogenesis, malignant transformation, clinical manifestations, and diagnosis of Barrett's esophagus are discussed separately. (See "Pathogenesis of Barrett's esophagus and its malignant transformation" and "Epidemiology, clinical manifestations, and diagnosis of Barrett's esophagus".)