Editor's Note:
Barrett's esophagus is a metaplastic lesion that is generally confined to the lower region of the esophagus, and which considerably increases the risk for esophageal adenocarcinoma. The risk for progression to malignancy has been estimated at 0.5% to 1% per year. The strongest associated risk factor for the development of this precancerous lesion is long-standing gastroesophageal reflux disease. Frequent exposure to such caustic refluxate erodes the regular squamous epithelium, which may subsequently be replaced with the specialized intestinal metaplasia known as Barrett's esophagus. Medscape spoke with Prateek Sharma, MD, Professor of Medicine, University of Kansas School of Medicine, Kansas City, Missouri, to explore the latest advances in our understanding of this clinically important condition, with a focus on the implications for clinical practice, as framed by data presented at Digestive Disease Week (DDW) 2008.
Medscape: The American College of Gastroenterology (ACG) recently issued updated guidelines on the diagnosis, surveillance, and treatment of Barrett's esophagus.[1] What are the significant changes in these guidelines since they were last updated in 2002, and how will these new recommendations translate into clinical practice?
Dr. Sharma:The significant changes in the ACG updated guidelines pertain to approaches to patients with dysplasia in Barrett's esophagus.
