| Theme | Barrett's Esophagus | |
|---|---|---|
| Title | Medical Management and Endoscopic Surveillance of Barrett's Esophagus | |
| Publish Date | 2007/01 | |
| Author | Yuji Amano | Division of Gastrointestinal Endoscopy, Shimane University Hospital |
| Author | Nobuyuki Moriyama | Department of Gastroenterology and Hepatology, Shimane University, School of Medicine |
| Author | Yoshikazu Kinoshita | Department of Gastroenterology and Hepatology, Shimane University, School of Medicine |
| [ Summary ] | The most important role for medical management of Barrett's esophagus is suppression of associated carcinogenesis. The efficacies of PPI and endoscopic surgery with PPI administration for Barrett's esophagus have been assessed, and some benefits have been demonstrated in Barrett's regression and / or suppression of Barrett's carcinogenesis by some investigators. However, other investigators have reported that many cases treated with endoscopic surgery and PPI administration showed a relapse and recurrence of Barrett's dysplastic lesions. Thus, there is still conflict concerning whether these treatments demonstrate good outcomes or not. Further studies are required to clearly elucidate their effect. On the other hand, administration of NSAIDs or selective COX-2 inhibitors has been proven to suppress Barrett's carcinogenesis. A prospective study with a large population is now ongoing and will undoubtedly demonstrate the efficacy of these drugs. In Japan, endoscopic Barrett's surveillance is also considered to be needed at present since the number of patients with Barrett's cancer may explosively increase as has occured in Western countries. However, patients with Barrett's esophagus in Japan show different characteristics from those in Western countries. For instance, a majority of patients have short segment type Barrett's esophagus. Therefore, establishment of a unique surveillance method is required for Japanese Barrett's esophagus in the near future. |
|