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Update on Screening, Surveillance, and Treatment

Thomas G. Morales, MD; Richard E. Sampliner, MD

Arch Intern Med. 1999;159:1411-1416.

The last 2 decades have seen dramatic advances in Barrett's esophagus. The definition has evolved; the rising incidence of adenocarcinoma has been recognized; and effective therapy to control gastroesophageal reflux disease has been developed. Both proton pump inhibitor therapy and laparoscopic fundoplication represent major developments. Studies of patients with dysplasia have helped to clarify appropriate surveillance intervals and treatment strategies for these patients, although controversy still exists. The possibility of reversing Barrett's esophagus in selected high-risk patients offers major hope for the future prevention of adenocarcinoma of the esophagus.

From the Arizona Health Sciences Center, Tucson Veterans Affairs Medical Center, Tucson, Ariz. Dr Morales is now with Rocky Mountain Gastroenterology Associates, Wheat Ridge, Colo.

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