Pathophysiology and treatment of Barrett's esophagus.
Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the United States. About 10%-15% of patients with GERD develop Barrett's esophagus, which can progress to adenocarcinoma, currently the most prevalent type of esophageal cancer. The esophagus is normally lined by squamous mucosa, therefore, it is clear that for adenocarcinoma to develop, there must be a sequence of events that result in transformation of the normal squamous mucosa into columnar epithelium. This sequence begins with gastroesophageal reflux, and with continued injury metaplastic columnar epithelium develops. This article reviews the pathophysiology of Barrett's esophagus and implications for its treatment. The effect of medical and surgical therapy of Barrett's esophagus is compared.
Oh
Daniel S
DS
Department of Surgery, The University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States.
Demeester
Steven R
SR
D001471:Barrett Esophagus / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013505:Digestive System Surgical Procedures; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004947:Esophagus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D008679:Metaplasia; D011230:Precancerous Conditions / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
D005765:Gastrointestinal Agents