Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 29: Mr. Smith Has No Reflux Symptoms But Underwent Upper Endoscopy As Part Of A Celiac Sprue Evaluation. He Was Found To Have A 5-Mm Segment Of Columnar-Lined Esophagus Without Nodularity. Biopsies Showed Intestinal Metaplasia But No Dysplasia. What Is The Appropriate Follow-Up? (continued)

Based on the current definition proposed by the American College of Gastroenterology guidelines and the American Gastroenterological Association Chicago Workshop, this patient has Barrett’s esophagus. This working definition using displacement of the squamocolumnar junction proximal to the gastroesophageal junction with the presence of intestinal metaplasia on biopsy allows us to standardize our discussions. The entity of Barrett’s esophagus has evolved over the past several decades to now include segments of columnar-lined esophagus with intestinal metaplasia that are less than…