[Epidemiology and pathophysiology of Barrett esophagus]

The pathophysiology of Barrett's esophagus appears to be a sequential process; the squamous epithelium of the esophagus is replaced by multipotent undifferentiated cells; secondary to cellular damage in the course of gastroesophageal reflux disease these undifferentiated cells further differentiate under the ongoing influence of mucosal damage, thus forming the typical morphology of Barrett mucosa. While the prevalence of gastroesophageal reflux disease amounts to 10% to 30%, the prevalence of Barrett's esophagus is estimated to be 1% in the general population. The epidemiologic data of Barrett's esophagus gain special attention with regard to the fact that the specialized columnar epithelium with intestinal metaplasia represents the only recognized risk factor for the development of adenocarcinoma in the esophagus. Currently it is estimated that the risk of the development of an adenocarcinoma on the basis of Barrett's esophagus is about 30-50 fold higher than that in the general population.