Barrett esophagus

There continues to be great interest in Barrett esophagus, the premalignant lesion for adenocarcinoma of the esophagus and the esophagogastric junction. There were several publications this past year related to the epidemiology, pathogenesis, new methods for detection, biomarkers for stratifying patients by risk, and the treatment of patients with Barrett esophagus. Patients with intestinal metaplasia in short lengths of columnar mucosa in the distal esophagus (ie, short-segment Barrett esophagus) appear to be distinct from those with intestinal metaplasia in the gastric cardia. The reported risk of cancer in patients with Barrett esophagus is probably subject to publication bias, with small series reporting a higher incidence of cancer. New methods for the diagnosis and detection of intestinal metaplasia and dysplasia are being evaluated and may, in future, help in obtaining more accurate screening and more focused surveillance of patients with Barrett esophagus. The validation of biomarkers may help us to risk stratify patients at high risk for cancer development. Endoscopic mucosal resection appears to be a safe and effective technique for the resection and accurate diagnosis of dysplastic or cancerous areas within Barrett esophagus.