title: Gastroesophageal reflux, Barrett esophagus, and esophageal cancer: clinical applications.
abstract: Gastroesophageal reflux disease (GERD), a condition commonly encountered in the primary care setting, is a risk factor for adenocarcinoma of the esophagus. Despite the ubiquity of the complaint, considerable uncertainty exists with respect to several basic questions, including when to perform endoscopy in patients with chronic reflux symptoms and how to address the cancer risk associated with GERD. These clinical vignettes illustrate common clinical questions encountered in caring for patients with GERD, especially as they relate to the issue of cancer risk. Applying data reviewed in the companion article, we propose practical answers to common clinical situations regarding care of patients with reflux. We also present an algorithm for treatment of patients with chronic GERD symptoms.
authors.affiliation: Division of Digestive Diseases and Nutrition, Center for Esophageal Disease and Swallowing, CB#7080, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7080, USA. nshaheen@med.unc.edu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Shaheen
authors.forename: David F
authors.initials: DF
authors.lastname: Ransohoff
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000465:Algorithms; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000150:complications / Q000517:prevention & control*; D002908:Chronic Disease; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D004945:Esophagoscopy; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors; D012307:Risk Factors
chemical_list: D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors