GERD Best treatment for Barrett Esophagus?

DOCTOR'S VIEWS ARCHIVE

Topic: Irritable Bowel Syndrome (IBS), June 2000

Dr. Lee:
What is the best treatment for Barrett esophagus?

Dr. Marks:
Barrett esophagus is a condition of the lower esophagus in which long-standing acid reflux causes changes in the cells lining the esophagus which can progress to cancer. Fortunately, it occurs in less than 5% of patients with GERD.

The treatment of Barrett esophagus is similar to the treatment of GERD in general. However, the difference is that acid suppression should be maximized by using higher doses of medication or more than one drug, if necessary. Some gastroenterologists feel that the effectiveness of acid suppression and the need for changes in doses of medication should be determined by measuring the acid reflux in the esophagus. If acid still is refluxing on medication then the medication must be changed.

Because of the risk of developing esophageal cancer, patients with Barrett esophagus also should undergo regular endoscopies (EGD) with biopsy of the esophagus to detect early the changes that lead to cancer.

Dr. Lee:
Please also refer to our Barrett esophagus article to learn about procedures to destroy the precancerous lining of the esophagus before these cells start to transform into cancer.

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