Skip to main content

Advertisement

Log in

Clinical Guidelines Update on the Diagnosis and Management of Barrett’s Esophagus

  • Review
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Barrett’s esophagus is a condition in which metaplastic columnar epithelium replaces stratified squamous epithelium in the distal esophagus. This condition occurs due to chronic gastroesophageal reflux disease and is a risk factor for the development of esophageal adenocarcinoma. Multiple clinical guidelines have been published around the world in recent years to assist gastroenterologists in the management of these patients and have evolved as new data have become available. While some information such as surveillance technique has not drastically changed, there has been an evolution over the years in diagnostic criteria, screening and endoscopic therapy with a variety of subtle differences among the different guidelines. Herein, we highlight areas of agreement and disagreement on definitions, screening, surveillance, and treatment techniques among these guidelines for the optimal management of Barrett’s esophagus patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Weusten B, Bisschops R, Coron E, et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2017;49:191–198.

    Article  PubMed  Google Scholar 

  2. Shaheen NJ, Falk GW, Iyer PG, Gerson LB. American College of gastroenterology. ACG clinical guideline: diagnosis and management of Barrett’s Esophagus. Am J Gastroenterol. 2016;111:30–50.

    Article  PubMed  CAS  Google Scholar 

  3. Whiteman DC, Appleyard M, Bahin FF, et al. Australian clinical practice guidelines for the diagnosis and management of Barrett’s esophagus and early esophageal adenocarcinoma. J Gastroenterol Hepatol. 2015;30:804–820.

    Article  PubMed  Google Scholar 

  4. Fock KM, Talley N, Goh KL, et al. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett’s oesophagus. Gut. 2016;65:1402–1415.

    Article  PubMed  Google Scholar 

  5. Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63:7–42.

    Article  PubMed  Google Scholar 

  6. ASGE Standards of Practice Committee, Evans JA, Early DS, et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointest Endosc. 2012;76:1087–1094.

    Article  Google Scholar 

  7. American Gastroenterological Association, Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association medical position statement on the management of Barrett’s esophagus. Gastroenterology. 2011;140:1084–1091.

    Article  Google Scholar 

  8. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology. 2006;131:1392–1399.

    Article  PubMed  Google Scholar 

  9. Ganz RA, Allen JI, Leon S, Batts KP. Barrett’s esophagus is frequently over diagnosed in clinical practice: results of the Barrett’s Esophagus Endoscopic Revision (BEER) study. Gastrointest Endosc. 2014;79:565–573.

    Article  PubMed  Google Scholar 

  10. Thota PN, Vennalaganti P, Vennelaganti S, et al. Low risk of high-grade dysplasia or esophageal adenocarcinoma among patients with Barrett’s esophagus less than 1 cm (irregular Z Line) within 5 years of index endoscopy. Gastroenterology. 2017;152:987–992.

    Article  PubMed  Google Scholar 

  11. Harrison R, Perry I, Haddadin W, et al. Detection of intestinal metaplasia in Barrett’s esophagus: an observational comparator study suggests the need for a minimum of eight biopsies. Am J Gastroenterol. 2007;102:1154–1161.

    Article  PubMed  Google Scholar 

  12. Bhat SK, McManus DT, Coleman HG, et al. Oesophageal adenocarcinoma and prior diagnosis of Barrett’s oesophagus: a population-based study. Gut. 2015;64:20–25.

    Article  PubMed  Google Scholar 

  13. Fock KM, Talley N, Goh KL, et al. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett’s oesophagus. Gut. 2016;65:1402–1415.

    Article  PubMed  Google Scholar 

  14. di Pietro M, Fitzgerald RC. BSG Barrett’s guidelines working group. Revised British Society of Gastroenterology recommendation on the diagnosis and management of Barrett’s oesophagus with low-grade dysplasia. Gut. 2018;67:392–393.

    Article  PubMed  Google Scholar 

  15. Katzka DA, Falk GW. Management of low-grade dysplasia in Barrett’s Esophagus: incremental progress continues. Gastroenterology. 2017;152:928–932.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gary W. Falk.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clermont, M., Falk, G.W. Clinical Guidelines Update on the Diagnosis and Management of Barrett’s Esophagus. Dig Dis Sci 63, 2122–2128 (2018). https://doi.org/10.1007/s10620-018-5070-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-018-5070-z

Keywords

Navigation