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Barrett’s esophagus is detected in 3 to 14% of adults with symptoms of gastroesophageal reflux disease (GERD) who undergo an endoscopy examination. Barrett’s esophagus is characterized by the replacement of the squamous mucosa in the lower portion of the esophagus with a columnar epithelium. On endoscopy, the columnar-cell–lined segment appears as reddened mucosa originating from the gastroesophageal junction and is frequently associated with a hiatal hernia. Histopathological findings include a mosaic of intestinal and gastric cell types. Clinically, a diagnosis of Barrett’s esophagus is established when endoscopic findings reveal a columnar epithelium measuring at least 1 cm long in combination with confirmed goblet-cell lineages, a condition termed intestinal metaplasia ([X: seen in figure | IG: seen in figure; swipe left for video]). Endoscopists record the length of the segment of Barrett’s esophagus in centimeters because longer segments are associated with a greater chance of progression to cancer. On the basis of historical studies, 3 cm is used as a cutoff between short segments (<3 cm) and long segments (≥3 cm). Establishing whether a segment is short or long determines how often monitoring should take place owing to the altered pathophysiological features of long segments with intestinal-cell lineages coupled with greater molecular instability.
Learn more in the Clinical Practice article “Barrett’s Esophagus” by Rebecca C. Fitzgerald, MD (@RFitzgerald_lab), from the University of Cambridge (@cambridge_uni): https://t.co/DEfidqHRVI