| Barrett’s esophagus (BE) is one of the most common conditions encountered by gastroenterologist in the U.S. Growing evidence also has suggested the increasing incidence of BE in Asian countries, which has raised the importance of awareness and knowledge about BE among Japanese gastroenterologists. Robust evidence on the natural history, risk factors and management strategy for BE mainly reported from the U.S. and other western countries will help Japanese gastroenterologists understand the disease and implement management algorithm. BE is a well established malignant precursor for esophageal adenocarcinoma (EAC). Despite of substantial numbers of subjects with GERD in the U.S., screening for BE in general population is not recommended. Routine screening is limited to men with reflux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3 years. Endoscopic ablative therapy is recommended for patients with BE with high-grade dysplasia, as well as T1a esophageal adenocarcinoma. In this session, I will give an overview of the definition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. |
