Clinical Gastroenterology Vol.24 No.5(10)

Theme GERD -- Recent Clinical Advances
Title Current Concepts Concerning Barrett's Esophagus
Publish Date 2009/05
Author Satoshi Tokioka Second Department of Internal Medicine, Osaka Medical College
Author Eiji Umegaki Second Department of Internal Medicine, Osaka Medical College
Author Nozomi Takeuchi Second Department of Internal Medicine, Osaka Medical College
Author Toshihisa Takeuchi Second Department of Internal Medicine, Osaka Medical College
Author Yukiko Yoda Second Department of Internal Medicine, Osaka Medical College
Author Kazuhide Higuchi Second Department of Internal Medicine, Osaka Medical College
[ Summary ] Barrett's esophagus was first recognized in 1950 by Norman Rupert Barrett, a British surgeon who reported on shortened esophagi and ectopic gastric mucosa accompaning stomachs with thorax as a special state for patients with ulcers. Tissue associated with Barrett's esophagus is substituted for consecutive columnar epithelia from squamous epithelium due to GERD. Recently, the ratio of adenocarcinoma associated with esophageal cancer has exceeded the frequency of squamous cell carcinoma in Western countries. In addition, a significant increase (more than 6 times) in esophageal cancer from Barrett's esophagus has been reported over the last 25 years. The frequency of reflux esophagitis and GERD has risen in Japan. The increase in Barrett's esophagus has been attributed to the westernization of eating habits, obesity and a decrease in Helicobacter pylori infection rates. In addition, there is concern over the increase in Barrett's cancer. Reported increases in adenocarcinoma incidence due to Barrett's esophagus have been as much as 0.5% a year. Therefore, we must recognize Barrett's esophageal lesions as precursors of adenocarcinoma. Current concepts concerning Barrett's esophagus are discussed.
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