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conferenceseries
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Volume 7, Issue 7 (Suppl)
J Gastrointest Dig Syst
ISSN: 2161-069X JGDS, an open access journal
Gastroenterologists 2017
December 14-15, 2017
December 14-15, 2017 Dubai, UAE
11
th
World
Gastroenterologists Summit
Barrett’s esophagus: Current controversies
Chidi Amadi
Royal Surrey County Hospital NHS Foundation Trust, UK
E
sophageal adenocarcinoma is rapidly increasing in Western countries. This tumor frequently presents late in its course
with metastatic disease and has a very poor prognosis. Barrett's esophagus is an acquired condition whereby the native
squamous mucosa of the lower esophagus is replaced by columnar epithelium following prolonged gastro-esophageal reflux
and is the recognized precursor lesion for esophageal adenocarcinoma. There are multiple national and society guidelines
regarding screening, surveillance and management of Barrett's esophagus, however all are limited regarding a clear evidence
base for a well-demonstrated benefit and cost-effectiveness of surveillance and robust risk stratification for patients to best
use resources. Currently the accepted risk factors upon which surveillance intervals and interventions are based are Barrett's
segment length and histological interpretation of the systematic biopsies. Further patient risk factors including other
demographic features, smoking, gender, obesity, ethnicity, patient age, biomarkers and endoscopic adjuncts remain under
consideration and are discussed in full. Recent evidence has been published to support earlier endoscopic intervention by
means of ablation of the metaplastic Barrett's segment when the earliest signs of dysplasia are detected. Further work should
concentrate on establishing better risk stratification and primary and secondary preventative strategies to reduce the risk of
adenocarcinoma of the esophagus.
chidi.amadi@btinternet.comJ Gastrointest Dig Syst 2017, 7:7 (Suppl)
DOI: 10.4172/2161-069X-C1-062