Barrett's esophagus: a review.

Barrett's esophagus [BE] is usually an acquired, condition in which specialized metaplastic intestinal columnar epithelium with goblet cells replaces the normal stratified squamous epithelium anywhere in the esophagus. It results from chronic irritation of esophageal mucosa by refluxed gastric contents. The importance of BE comes from its potential risk of progression to adenocarcinoma. The development of dysplastic changes in Barrett's metaplasia increases this risk markedly. However, the true incidence and the likelihood of adenocarcinoma developing in such individuals with dysplasia over a lifetime are not well defined. Histopathology of esophageal biopsy is mandatory for the diagnosis, because clinical, radiological and endoscopic findings in such cases can only suspect the disease. The exact prevalence of BE in the general population is difficult to estimate, however worldwide distribution of the disease vary considerably. BE has also been reported to occur in children. It has bimodal age distribution in adults. Despite the considerable attempts to treat BE, complete elimination of this premalignant epithelium is rare. The impact of medical or surgical therapy on the risk of malignancy remains obscure. To date, the optimal form of treatment whether by drugs and/or endoscopic ablation or by surgery remains undetermined.