title: Past, present and future of Barrett's oesophagus.
abstract: Barrett's oesophagus is a condition which predisposes towards development of oesophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence in the Western world over the past three decades. There have been tremendous advances in the field of Barrett's oesophagus, not only in diagnostic modalities, but also in therapeutic strategies available to treat this premalignant disease. In this review, we discuss the past, present and future of Barrett's oesophagus. We describe the historical and new evolving diagnostic criteria of Barrett's oesophagus, while also comparing and contrasting the British Society of Gastroenterology guidelines, American College of Gastroenterology guidelines and International Benign Barrett's and CAncer Taskforce (BOBCAT) for Barrett's oesophagus. Advances in endoscopic modalities such as confocal and volumetric laser endomicroscopy, and a non-endoscopic sampling device, the Cytosponge, are described which could aid in identification of Barrett's oesophagus. With regards to therapy we review the evidence for the utility of endoscopic mucosal resection and radiofrequency ablation when coupled with better characterization of dysplasia. These endoscopic advances have transformed the management of Barrett's oesophagus from a primarily surgical disease into an endoscopically managed condition.
authors.affiliation: MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: W K
authors.initials: WK
authors.lastname: Tan
authors.affiliation: MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: di Pietro
authors.affiliation: MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom. Electronic address: rcf29@mrc-cu.cam.ac.uk.
authors.forename: R C
authors.initials: RC
authors.lastname: Fitzgerald
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation; D003452:Cryosurgery; D003584:Cytological Techniques / Q000295:instrumentation; D000069916:Endoscopic Mucosal Resection; D004938:Esophageal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D016629:Esophagectomy; D004945:Esophagoscopy / Q000379:methods*; D006801:Humans; D018613:Microscopy, Confocal; D017410:Practice Guidelines as Topic; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D000071165:Trefoil Factor-3 / Q000032:analysis; D057832:Watchful Waiting
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D000071165:Trefoil Factor-3
keywords: Barrett's oesophagus; Cytosponge; Diagnosis; Endoscopy; Guidelines; Management