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World J Gastroenterol. Aug 14, 2010; 16(30): 3762-3772
Published online Aug 14, 2010. doi: 10.3748/wjg.v16.i30.3762
Pathophysiology and treatment of Barrett’s esophagus
Daniel S Oh, Steven R DeMeester
Daniel S Oh, Steven R DeMeester, Department of Surgery, The University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
Author contributions: Both authors contributed to this paper.
Correspondence to: Steven R DeMeester, MD, Associate Professor, Department of Surgery, The University of Southern California, Keck School of Medicine, 1510 San Pablo St., Suite 514, Los Angeles, CA 90033, United States. sdemeester@surgery.usc.edu
Telephone: +1-323-4429066 Fax: +1-323-4425872
Received: April 24, 2010
Revised: June 7, 2010
Accepted: June 14, 2010
Published online: August 14, 2010
Abstract

Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the United States. About 10%-15% of patients with GERD develop Barrett’s esophagus, which can progress to adenocarcinoma, currently the most prevalent type of esophageal cancer. The esophagus is normally lined by squamous mucosa, therefore, it is clear that for adenocarcinoma to develop, there must be a sequence of events that result in transformation of the normal squamous mucosa into columnar epithelium. This sequence begins with gastroesophageal reflux, and with continued injury metaplastic columnar epithelium develops. This article reviews the pathophysiology of Barrett’s esophagus and implications for its treatment. The effect of medical and surgical therapy of Barrett’s esophagus is compared.

Keywords: Gastroesophageal reflux disease; Barrett’s esophagus; Lower esophageal sphincter; Esophageal motility; Proton pump inhibitors; Antireflux surgery