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Barrett Esophagus

Eric Ji-Yuan Mao, MD and Harlan G. Rich, MD, FACP, AGAF Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Metaplasia of the distal esophageal mucosa from native stratified squamous epithelium to abnormal columnar (intestinalized) epithelium, likely as a consequence of chronic GERD

  • Predisp...

DIAGNOSIS

HISTORY

  • Assess underlying risk factors.

  • Common GERD symptoms: heartburn, regurgitation

  • Less common symptoms include chest pain, odynophagia, chronic cough, water brash, globus sensation, laryng...

TREATMENT

ALERT

Neither suppression of gastric acid production via high-dose PPIs nor reduction in esophageal acid exposure via antireflux surgery induces regression of BE. These therapies may, however...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Surveillance (to detect high-grade dysplasia or early carcinoma), although, controversial, is recommended in patients with histologically confirmed BE—especially ...

REFERENCES

1
1 Spechler SJ, Sharma P, Souza RF, et al; for American Gastroenterological Association. American Gastroenterological Association medical position statement on the management of Barrett’s e...

ADDITIONAL READING

  • Dunbar KB, Spechler SJ. Controversies in Barrett esophagus. Mayo Clin Proc.  2014;89(7):973–984. {L-End} {L-End} [View Abstract on OvidMedline]

  • Zimmerman TG. Common questions...

CODES

ICD10

  • K22.70 Barrett’s esophagus without dysplasia

  • K22.719 Barrett’s esophagus with dysplasia, unspecified

  • K22.710 Barrett’s esophagus with low grade dysplasia

  • K22.711 Barrett’s esophagus with high ...

CLINICAL PEARLS

  • The incidence of esophageal cancer is rising faster than any other major malignancy. BE is a precursor for esophageal carcinoma.

  • The highest incidence of BE is in white males >50 yea...

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