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Related Concept Videos

Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
587
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
746
Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

841
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
841
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

399
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Related Experiment Video

Updated: Jan 10, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
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Esophageal Function Testing Identifies Barrett's Esophagus Patients With Pathological Acid Exposure at Risk for

Edoardo Vespa1, Edi Viale1, Ernesto Fasulo1

  • 1Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Faculty of Medicine, Università Vita-Salute San Raffaele, Milan, Italy.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|November 24, 2025
PubMed
Summary

Pathological esophageal acid exposure persists in nearly one-third of Barrett's esophagus patients on proton pump inhibitors (PPIs). This condition significantly increases the risk of developing esophageal neoplasia.

Keywords:
24-hour pH ImpedanceBarrett’s EsophagusHigh-resolution ManometryNeoplasiaProton Pump Inhibitors

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An Immunofluorescent Method for Characterization of Barrett’s Esophagus Cells
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Area of Science:

  • Gastroenterology
  • Esophageal Diseases
  • Oncology

Background:

  • Barrett's esophagus (BE) patients on proton pump inhibitor (PPI) therapy may still experience pathological esophageal acid exposure.
  • Esophageal function testing can assess acid exposure and predict disease progression in BE patients.

Purpose of the Study:

  • To determine the role of esophageal function testing in assessing acid exposure in BE patients on PPIs.
  • To evaluate the predictive value of acid exposure time (AET) for neoplasia in BE patients.

Main Methods:

  • Retrospective study of 135 asymptomatic BE patients using high-resolution manometry and 24-hour pH impedance testing on PPIs.
  • Pathological reflux defined as AET >6%. Receiver operator characteristic analysis used to assess AET's predictive performance for neoplasia.

Main Results:

  • 27% of patients exhibited pathological reflux despite PPI treatment; 67% of these were on standard-dose PPI.
  • Pathological reflux was the sole independent predictor of neoplasia (aOR, 9.62; P < .001).
  • AET ≥6% demonstrated good predictive performance for neoplasia (AUC, 0.816; 77% sensitivity; 78% specificity).

Conclusions:

  • Nearly one-third of asymptomatic BE patients on PPIs show pathological reflux.
  • Normal AET is observed in one-third of patients on standard-dose PPI.
  • Pathological reflux is linked to a ninefold increased risk of neoplasia in BE patients.