Aggressive acid control: minimizing progression of Barrett's esophagus

Barrett's esophagus (BE) is a change in the cellular structure of the lower esophagus believed by many to be caused by frequent acid exposure. The condition is troublesome because of a tendency toward cell proliferation, dysplastic transformation, and cancerous changes within the lesions. It is speculated that the pronounced increase in esophageal adenocarcinoma during the past 25 years may be attributable to acid reflux and associated BE. Strict acid control may cause lesion regression in these patients. However, pH monitoring to confirm adequate acid control is essential, and more than 1 drug may be needed to achieve adequate acid control and manage many patients. More research is needed to determine whether aggressive acid control reduces the dysplasia and cancer risk associated with BE.