Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 1: An 81-Year-Old Healthy Male Is Found To Have A 12-Cm Long Segment Barrett’S Esophagus And Several Tiny Raised Lesions, With Moderate To High Grade Dysplasia In One Location. What Do I Tell The Patient? What Therapy Is Appropriate? (continued)

Fauze Maluf-Filho, , MD, PhD, FASGE; Paulo Sakai, MD, PhD, FASGE

Barrett’s esophagus (BE) is defined as the presence of specialized columnar metaplasia at the distal esophagus in response to the chronic reflux of gastroduodenal content into the esophagus. Compared with other patients with gastroesophageal ref lux disease, patients with BE present with longer acid and bile exposure. It has been recently acknowledged that the risk of adenocarcinoma associated with BE was overestimated.1 One case of cancer for approximately 1000 patients with BE per year is expected. Long segments of BE (> 3 cm) have a higher risk of cancer when compared with…