Barrett's esophagus.

Barrett's esophagus is a complication of gastroesophageal reflux disease that is diagnosed with increasing frequency in connection with the increased utilization of upper endoscopy. It remains unclear why some patients with gastroesophageal reflux disease develop Barrett's esophagus while others do not. The association of Barrett's esophagus and adenocarcinoma is well established; if not for this fact, Barrett's esophagus would be of little clinical importance. Endoscopic surveillance with a rigorous biopsy protocol for the detection of dysplasia or early adenocarcinoma is indicated in any patient with Barrett's esophagus who is a candidate for surgery. New therapeutic strategies, including profound acid suppression with proton pump inhibitors, laser ablation of Barrett's epithelium, and photodynamic therapy, are currently under evaluation for the treatment of Barrett's esophagus.