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Upper Endoscopy for GI Fellows pp 43–53Cite as

Diagnosis and Management of Barrett’s Esophagus

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Abstract

There has been an increase in the incidence of esophageal adenocarcinoma in the USA since the 1970s. The goal of screening and surveillance endoscopy for Barrett’s esophagus was to identify and then subsequently treat the patients who are at the highest risk for the development of esophageal adenocarcinoma. In general, the American GI societies, including the American Gastroenterological Society (AGA), American College of Gastroenterology (ACG), and American Society for Gastrointestinal Endoscopy (ASGE), are in agreement with screening guidelines for Barrett’s esophagus. Screening should be considered for patients at higher risk for the development of esophageal cancer, and endoscopic screening has not been advocated for the general population. Non-dysplastic Barrett’s esophagus is most often followed with surveillance endoscopy and biopsies every 3–5 years. Since non-dysplastic Barrett’s esophagus has a low risk of progression to esophageal adenocarcinoma, endoscopic treatment is not generally recommended. Endoscopic treatment with ablative therapy, mechanical therapy, or combination of both is recommended for patients with Barrett’s esophagus with confirmed low-grade dysplasia, high-grade dysplasia, and intramucosal carcinoma. After complete eradication of both intestinal metaplasia and dysplasia, patients should continue to have endoscopic surveillance to monitor for recurrence of disease.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, University of Utah, 30N 1900 E Room 4R118, Salt Lake City, UT, 84132, USA

    Kathryn R. Byrne

  2. Gastroenterology and Hepatology, University of Utah School of Medicine, Huntsman Cancer Center, 30N 1900E 4R118, Salt Lake City, UT, 84132, USA

    Douglas G. Adler

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  1. Kathryn R. Byrne
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Correspondence to Douglas G. Adler .

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Editors and Affiliations

  1. Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, Salt Lake City, Utah, USA

    Douglas G. Adler

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Endoscopic ablation of Barrett’s Esophagus (MP4 202137 kb)

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Byrne, K.R., Adler, D.G. (2017). Diagnosis and Management of Barrett’s Esophagus. In: Adler, D. (eds) Upper Endoscopy for GI Fellows. Springer, Cham. https://doi.org/10.1007/978-3-319-49041-0_5

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  • DOI: https://doi.org/10.1007/978-3-319-49041-0_5

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