Barrett's esophagus is metaplasia of the lower end of the esophagus caused by chronic reflux esophagitis and is present in about 10% of patients who present with reflux. It is a premalignant condition and is associated with an increased risk of esophageal cancer.

Treatment

Current recommendations are for endoscopy and biopsy (looking for dysplastic changes) every 12 months or so whilst the underlying reflux should be controlled with H2 antagonists or proton pump inhibitor drugs. In severe dysplasia, laser treatment is being used, while overt malignancy requires surgery.

Pathology

It is marked by the presence of columnar cell epithelium in the lower esophagus which replaces the squamous cell epithelium. This is an example of metaplasia. The columnar epithelium is better able to withstand the erosive action of the gastric secretions. There is an increased cancer risk of the adenocarcinoma type.