Barrett Esophagus ; diagnosis ; Dissent and Disputes ; Humans

Barrett's esophagus is an acquired condition in which the stratified squamous epithelium is replaced by metaplastic, intestinal-type columnar epithelium. It develops as a result of chronic gastroesophageal reflux disease, and predisposes to the development of esophageal adenocarcinoma. This review is focused on histologic diagnosis and differential diagnosis of Barrett's esophagus.
Adenocarcinoma ; Barrett Esophagus* ; Diagnosis ; Diagnosis, Differential ; Epithelium ; Gastroesophageal Reflux

Barrett's esophagus (BE) is a frequent complication of gastroesophageal reflux disease, an acquired condition resulting from persistent mucosal injury to the esophagus. The incidence of Barrett's metaplasia and Barrett's adenocarcinoma has been increasing, but the prognosis of Barrett's adenocarcinoma is worse because individuals present at a late stage. Attempts have been made to intervene at early stage using surveillance programmes, although proof of efficacy of endoscopic surveillance is lacking. There is much to be learned about BE. Whether adequate control of gastroesophageal reflux early in the disease alters the natural history of Barrett's change once it has developed remains unanswered. Thus there is great need for carefully designed large randomised controlled trials to address these issues in order to determine how best to manage patients with BE. The AspECT and BOSS clinical trials proride this basis.
Adenocarcinoma ; Barrett Esophagus* ; Diagnosis* ; Esophagus ; Gastroesophageal Reflux ; Humans ; Incidence ; Mass Screening* ; Metaplasia ; Natural History ; Prognosis

Barrett's esophagus is considered as a premalignant condition in which columnar epithelium replaces the normal esophageal squamous epithelium. The diagnosis of Barrett's esophagus is based on the endoscopic finding of columnar epithelium lining the distal esophagus and histologic confirmation of the presence of specialized intestinal metaplasia. According to the extent of the metaplastic lining from the esophagogastric junction, Barrett's esophagus has been divided into long-segment (> or =3 cm in length) and short-segment (<3 cm in length). Long-segment Barrett's esophagus can be easily identified at endoscopy, but it is difficult to separate short-segment Barrett's esophagus from intestinal metaplasia of cardia. It has been reported that Barrett's CK 7/20 pattern is an objective marker of Barrett's mucosa, and can differentiate Barrett's mucosa from gastric intestinal metaplasia. We report here two cases of adenocarcinoma of esophagus arising from short-segment Barrett's esophagus, diagnosed by endoscopic and histologic findngs, and treated by endoscopic mucosal resection.
Adenocarcinoma* ; Barrett Esophagus* ; Cardia ; Diagnosis ; Endoscopy ; Epithelium ; Esophagogastric Junction ; Esophagus ; Metaplasia ; Mucous Membrane

Capsule endoscopy can be a diagnostic option for patients with esophageal diseases who cannot tolerate esophagogastroduodenoscopy.Functional modifications of the capsule allow for thorough examination of the esophagus. Esophageal capsule endoscopy has so farfailed to show sufficient performance to justify the replacement of traditional endoscopy for the diagnosis of esophageal diseasesbecause the esophagus has a short transit time and common pathologies appear near the esophagogastric junction. However,technological improvements are being introduced to overcome the limitations of capsule endoscopy, which is expected to become agood alternative to conventional endoscopy.
Barrett Esophagus ; Capsule Endoscopy* ; Diagnosis ; Endoscopy ; Esophageal and Gastric Varices ; Esophageal Diseases ; Esophagogastric Junction ; Esophagus ; Humans ; Pathology

Barrett's esophagus is now clearly recognized as a preneoplasic condition. Progression of metaplasia through dysplasia to adenocarcinoma is a widely accepted theory for esophageal carcinogenesis. That high grade dysplasia is frequently found in association with esophageal adenocarcinoma. Long-term endoscopic surveillance of high grade dysplasia in Barrett's esophagus facilitates detection and treatment of esophageal cancers in the early stage.
Barrett Esophagus ; diagnosis ; pathology ; therapy ; Esophageal Neoplasms ; diagnosis ; Esophagoscopy ; Humans ; Hyperplasia ; pathology ; Precancerous Conditions ; diagnosis

A casts of Barrett's esophagus complicated with stricture is reported. A 82 years old male was undergone distal esophagectomy and esophagogastrostomy on suspicion of malignancy. The microscopic examination of specimen taken from the lesion revealed the "tall columnar cells" which were indicative of Barrett's esophagus, hence the diagnosis. Barrett's esophagus is a rare disease in Korea. Because of the malignant potential of the disease, surgery involving esophagectomy is often required.
Aged, 80 and over ; Barrett Esophagus* ; Constriction, Pathologic ; Diagnosis ; Esophageal Stenosis* ; Esophagectomy ; Humans ; Korea ; Male ; Rare Diseases

BACKGROUND/AIMS: The higher prevalence of gastroesophageal reflux disease has preceded the increase of Barrett's esophagus and esophageal adenocarcinoma in Western countries. An increase of Barrett's esophagus and esophageal adenocarcinoma can also be predicted due to the increase of gastroesophageal reflux disease in Asia. Therefore, the ability of endoscopists to detect Barrett's esophagus can be important in the future. The aim of this study was to examine whether a short education program could improve the ability of gastrointestinal endoscopists and nurses to detect Barrett's esophagus. MATERIALS AND METHODS: Endoscopists and nurses of Gastrointestinal Endoscopic Center in Kosin Uinversity Gospel Hospital were enrolled in this study. Endoscopic images of biopsy proven Barrett's esophagus and normal gastroesophageal junction were obtained with conventional endoscopy. Thirty-seven still images of conventional endoscopy were used for slide test before and after 15 minutes education on Barrett's esophagus. RESULTS: Diagnostic ability of the doctor group after education did not changed (pre-education 79.6% vs. post-education 79.3%, P=0.906). Nurse group showed improved diagnostic ability for Barrett's esophagus after education (pre-education 68.7% vs. post-education 75.5%, P=0.008). After a short education program, inter-observer agreement of endoscopic diagnosis of Barrett's esophagus was improved in both doctor and nurse groups (doctor inter-observer correlation coefficient [ICC], 0.684→0.879; nurse ICC, 0.524→0.862). CONCLUSIONS: Even a short education program can improve the diagnostic ability, especially inter-observer agreement of endoscopic diagnosis for Barrett's esophagus. Further studies are needed to establish a role of education to improve diagnostic ability of Barrett's esophagus.
Adenocarcinoma ; Asia ; Barrett Esophagus* ; Biopsy ; Diagnosis ; Education* ; Endoscopy ; Esophagogastric Junction ; Gastroesophageal Reflux ; Prevalence

Barrett's esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.
Adenocarcinoma ; Barrett Esophagus ; Diagnosis ; Endoscopy, Gastrointestinal ; Esophageal Neoplasms ; Gastroenterology ; Mucous Membrane

Barrett's esophagus (BE) is one of the most prominent diseases in Western countries because of its potential to progress to dysplasia or adenocarcinoma. Recently, the American College of Gastroenterology (ACG), American Gastroenterology Association (AGA), and European Society of Gastrointestinal Endoscopy (ESGE) developed clinical guidelines for the diagnosis and management of BE. All three guidelines commonly stressed the necessity of the endoscopic eradication of confirmed, nonnodular low grade dysplasia or high grade dysplasia, as well as the endoscopic elimination of the remaining BE after an endoscopic resection of visible mucosal abnormalities. An endoscopic resection is also considered for the optimal management of esophageal adenocarcinoma confined to the mucosa (T1a), and even in selective cases of submucosal invasion (T1b). As endoscopic therapy becomes the mainstay for the treatment of BE and its complications, the eligibility of pathologic or endoscopic experts and the BE expert center are being set and strengthened. This paper introduces the statements of the ACG, AGA and ESGE guidelines and compares the similarities and differences between them.
Adenocarcinoma ; Barrett Esophagus ; Diagnosis ; Endoscopy, Gastrointestinal ; Esophageal Neoplasms ; Gastroenterology ; Mucous Membrane