Diagnosis and management of Barrett's esophagus: What's next?
The past decade has led to marked improvements in our understanding regarding the pathogenesis and risk of progression of Barrett's esophagus (BE), enhanced imaging technology to improve dysplasia detection, and the development and refinement of endoscopic techniques, such as mucosal ablation and endoscopic mucosal resection(EMR), to eradicate BE. However, many questions remain including identifying which, if any, candidates are most appropriate for screening for BE; how to improve current surveillance protocols; predicting which patients with BE will develop neoplastic progression; identifying the most appropriate candidates for endoscopic eradication therapy; developing algorithms for appropriate management posteradication; and understanding the potential role of chemoprophylaxis. This article describes potential future advances regarding screening, surveillance, risk stratification, endoscopic eradication therapies, and chemoprevention and provides a potential future management strategy for patients with BE.
Division of Gastroenterology, University of California, 101 The City Drive, City Tower, Suite 400, Zot 4092, Irvine, Orange, CA 92868, USA.
V Raman
VR
Muthusamy
Prateek
P
Sharma
D001471:Barrett Esophagus / Q000175:diagnosis* / Q000628:therapy*; D018890:Chemoprevention / Q000639:trends*; D055088:Early Detection of Cancer / Q000639:trends*; D004945:Esophagoscopy / Q000639:trends*; D006801:Humans; D008403:Mass Screening / Q000639:trends; D018570:Risk Assessment / Q000639:trends*; D018571:Sentinel Surveillance