Barrett's esophagus.

Abstract

Barrett's esophagus is the condition wherein columnar epithelium replaces squamous epithelium in the esophagus. The condition is named for the late Mr Normal Barrett, an English surgeon whose most renowned publication, ironically, is a treatise contending that the esophagus cannot be lined by columnar epithelium. The eponym is used commonly despite Mr Barrett's mistaken contention, although some European authors still prefer to call the condition "endobrachyesophagus." Barrett's esophagus appears to be a sequela of gastroesophageal reflux disease (GERD), and it is the major known risk factor for esophageal adenocarcinoma. Barrett's esophagus is usually discovered during endoscopic evaluation of patients who have symptoms caused by GERD or esophageal cancer. Consequently, data on the clinical features of Barrett's esophagus are derived primarily from studies on symptomatic patients in whom the condition was recognized endoscopically. Recent investigations suggest that more than 90% of cases of Barrett's esophagus in the general population are not recognized by physicians, and many of these unrecognized patients have few or no symptoms of GERD. It is important to appreciate, therefore, that conclusions drawn from studies on patients with clinically apparent disease are not necessarily applicable to the "silent majority" of individuals with Barrett's esophagus.