Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2015; 21(21): 6479-6490
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6479
Recent developments in pathogenesis, diagnosis and therapy of Barrett's esophagus
Magnus Halland, David Katzka, Prasad G Iyer
Magnus Halland, David Katzka, Prasad G Iyer, Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN 55905, United States
Author contributions: Halland M contributed to literature review and drafting of manuscript; Katzka D contributed to drafting of manuscript and critical review of manuscript; Iyer PG contributed to drafting of manuscript and critical review of manuscript; all authors approved the final version of the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Prasad G Iyer, MD, Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905, United States. iyer.prasad@mayo.edu
Telephone: +1-507-2844824
Received: December 10, 2014
Peer-review started: December 11, 2014
First decision: January 8, 2015
Revised: January 31, 2015
Accepted: April 28, 2015
Article in press: April 28, 2015
Published online: June 7, 2015
Abstract

The burden of illness from esophageal adenocarcinoma continues to rise in the Western world, and overall prognosis is poor. Given that Barrett’s esophagus (BE), a metaplastic change in the esophageal lining is a known cancer precursor, an opportunity to decrease disease development by screening and surveillance might exist. This review examines recent updates in the pathogenesis of BE and comprehensively discusses known risk factors. Diagnostic definitions and challenges are outlined, coupled with an in-depth review of management. Current challenges and potential solutions related to screening and surveillance are discussed. The effectiveness of currently available endoscopic treatment techniques, particularly with regards to recurrence following successful endotherapy and potential chemopreventative agents are also highlighted. The field of BE is rapidly evolving and improved understanding of pathophysiology, combined with emerging methods for screening and surveillance offer hope for future disease burden reduction.

Keywords: Barrett’s esophagus, Gastroesophageal reflux disease, Esophageal cancer, Esophagus

Core tip: This review highlights recent updates in the pathogenesis, diagnosis and therapy for Barrett’s esophagus (BE), the pre-malignant lesion for esophageal adenocarcinoma (EAC). The incidence of EAC continues to rise, and prognosis once diagnosed is poor. In this paper we critically reviewed the diagnostic criteria as well as new understanding of risk factors. Comparative recommendations from gastrointestinal societies are presented, and approaches to BE therapy, and management of recurrent BE after ablation is discussed.