Definition: normal lining of the esophagus is replaced by a type of lining normally found in the intestines (this is called intestinal metaplasia) as evidenced by the prescence of goblet cells.
- Occurs in ~10% of pts with GERD
- important to differentiate between short (<3cm) vs long (>3cm) Barrett's
- there is debate whether short segment Barretts is actually associated with a risk of metaplasia
- annual risk of adenoca in Barrett's is 0.8%/yr
- risk of metaplasia in long segment is high - 90%
- if high grade dysplasia found - risk of invasive focus is 50%
Pts with Barrett's Surgical Rx to manage reflux may be more important.
- medical therapy does not result in regression of Barrett's while there is some evidence that surgical therapy does result in regression of Barrett's
- Surgery may prevent the progression of metaplasia to dysplasia and subsequently cancer
- Medical therapy does not prevent alkaline reflux - whereas surgical therapy does and this may be a contributing factor to the presence of Barrett's
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