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Barrett Esophagus

Daniel J. Stein, MPH, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

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

  • Predispose...

DIAGNOSIS

HISTORY

  • Assess underlying risk factors.

  • Common GERD symptoms: heartburn, regurgitation

  • Atypical symptoms include chest pain, odynophagia, chronic cough, water brash, globus sensation, laryngiti...

TREATMENT

MEDICATION

  • The goal of medical therapy is to control GERD and reduce esophagitis.

  • Neither suppression of gastric acid production via high-dose PPIs nor reduction in esophageal acid exposure vi...

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
Spechler  SJ, Sharma  P, Souza  RF, et al; for American Gastroenterological Association. American Gastroenterological Association medical position statement on the ...

ADDITIONAL READING

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 to esophageal carcinoma.

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

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