Management of Barrett's Esophagus: Cases and Questions

Gastroesophageal reflux disease and Barrett's esophagus (BE) are associated with increased risk of esophageal adenocarcinoma. However, the majority of patients with adenocarcinoma have no gastroesophageal reflux disease symptoms, and few patients with adenocarcinoma have BE at the time of cancer diagnosis. Furthermore, the annual incidence of cancer in individuals with BE appears to be low. The utility of screening for BE in gastroesophageal reflux disease patients and of routine endoscopic monitoring in BE patients remain unclear. More prospective data on disease progression and an improved knowledge of risk factors are needed to help define optimal management strategies.