Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6479
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
Processing time: 183 Days and 9.7 Hours
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.
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.