Barrett esophagus

Last reviewed: 30 Dec 2022
Last updated: 19 Jan 2023

Summary

Definition

History and exam

Key diagnostic factors

  • heartburn
  • regurgitation
  • dysphagia
More key diagnostic factors

Other diagnostic factors

  • incidental finding during gastrointestinal endoscopy for other indication
  • chest pain
  • laryngitis
  • cough
  • dyspnea or wheezing
  • history of aspiration pneumonia
Other diagnostic factors

Risk factors

  • acid/bile reflux or GERD
  • increased age
  • white ethnicity
  • male sex
  • family history of Barrett esophagus or esophageal adenocarcinoma
  • obesity
  • smoking
More risk factors

Diagnostic investigations

1st investigations to order

  • upper GI endoscopy with biopsy
  • barium esophagogram
More 1st investigations to order

Emerging tests

  • chromoendoscopy
  • autofluorescence imaging
  • confocal laser endomicroscopy
  • optical coherence tomography
  • spectroscopy
  • transnasal endoscopy
  • capsule endoscopy
  • gelatin-coated sponge

Treatment algorithm

ACUTE

nondysplastic Barrett esophagus

low-grade dysplasia

high-grade dysplasia

Contributors

Authors

Andres F. Carrion, MD

Associate Professor of Medicine

Division of Gastroenterology and Hepatology

University of Miami

Miller School of Medicine

Miami

FL

Disclosures

AFC is a scientific advisor for Intercept Pharmaceuticals and Gilead Sciences, and is on the speaker bureau for Bristol-Myers Squibb, Intercept Pharmaceuticals, Merck, and Alexion.

Ricardo Badillo, MD

Assistant Professor of Medicine

Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

None

Marc J. Zuckerman, MD

Professor of Medicine

Chief

Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

MJZ is a contract researcher for Phathom Pharmaceuticals, and is on the speakers bureau for Salix Pharmaceuticals, Allergan Pharmaceuticals, and Takeda Pharmaceuticals.

Acknowledgements

Dr Andres F. Carrion, Dr Ricardo Badillo and Dr Marc J. Zuckerman would like to gratefully acknowledge Dr Vic Velanovich, the previous contributor to this topic.

Disclosures

VV is an author of a number of references cited in this topic.

Peer reviewers

Richard E. Sampliner, MD

Professor

Medicine Chief

Department of Gastroenterology

University of Arizona College of Medicine

Tucson

AZ

Disclosures

RES declares that he has no competing interests.

Peter McCulloch, MBChB, MA, MD, FRCS (Ed), FRCS (Glas)

Clinical Reader in Surgery

Nuffield Department of Surgery

University of Oxford

Oxford

UK

Disclosures

PM declares that he has no competing interests.

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  • Patient leaflets

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