Update on ablation for Barrett's esophagus

Endoscopic ablation has dramatically changed the treatment algorithm for patients with Barrett's esophagus. Studies clearly show the benefits of this approach for patients with high-grade dysplasia and intramucosal carcinoma. Recent studies also provide evidence in support of this approach for patients with low-grade dysplasia but not for patients with nondysplastic Barrett's epithelium. Endoscopic ablation is safe and efficacious in most but not all patients and disease progression may occur during initial therapy as well as after successful completion in a small difficult to identify subset of patients. Furthermore, the past year has provided us with a better understanding of the durability of endoscopic ablation with highly variable rates of disease recurrence. Studies are underway to help determine predictors of response and recurrence.