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ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus

Nicholas J Shaheen1, Gary W Falk2, Prasad G Iyer3

  • 1Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

The American Journal of Gastroenterology
|November 4, 2015
PubMed

Insights

Updated guidelines for Barrett's esophagus (BE) recommend screening high-risk men with reflux symptoms. Surveillance intervals for nondysplastic BE are extended to 3-5 years, and ablative therapy is advised for dysplasia and early cancer.

Area of Science:

  • Gastroenterology
  • Gastrointestinal Oncology

Background:

  • Barrett's esophagus (BE) is a common condition.
  • BE carries a risk of malignant progression.

Purpose of the Study:

  • To update clinical practice guidelines for managing patients with Barrett's esophagus.
  • Provide evidence-based recommendations for screening, surveillance, and treatment.

Main Methods:

  • Review of current literature and expert opinion.
  • Development of consensus-based recommendations by the American College of Gastroenterology.

Main Results:

  • Screening for BE is recommended for high-risk individuals, primarily men with reflux and other risk factors.
  • Surveillance intervals for nondysplastic BE are extended to 3-5 years.
  • Endoscopic ablative therapy is recommended for high-grade dysplasia, T1a esophageal adenocarcinoma, and low-grade dysplasia.

Conclusions:

  • The guidelines offer a pragmatic framework for BE patient care.
  • Routine biomarker panels and advanced imaging are not currently recommended.
  • Post-ablation surveillance is suggested due to recurrence risk.

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