Barrett's ulcer: the clinical significance today.

OBJECTIVES

The present day clinical significance and natural history of Barrett's esophageal ulcer are compared with those reported originally by Barrett.

METHODS

Records of patients with Barrett's ulcers followed by the Gastroenterology Service at the Medical College of Wisconsin were reviewed to assess the natural history of the ulcers in patients with Barrett's esophagus.

RESULTS

The histories of 14 patients with ulcers in Barrett's esophagus were reviewed. Average follow-up was 5 yr. Ulcers occurred in both short and long segment Barrett's and responded poorly to therapy. Dysplasia occurred in eight patients, and carcinoma developed in two.

CONCLUSIONS

Barrett's ulcers occur today and are difficult to manage, as they were 45 yr ago. Complications today, especially dysplasia and carcinoma, are different than those reported by Barrett (life-threatening hemorrhage, esophageal perforation, and stenosis.)