Medical Therapy for Barrett's Esophagus

Richard E. Sampliner, Lavanya Viswanathan, MD, MS, Prateek Sharma, MD, Domenico Ascenzio Farina, Sri Komanduri

Key Points

  • Emerging technologies may allow for more widespread screening of Barrett’s esophagus in high-risk individuals.
  • Keystone of medical therapy is acid suppression with proton pump inhibition.
  • Following diagnosis, interval surveillance endoscopy is performed to detect dysplasia and early adenocarcinoma with new technologies and devices allowing for better risk stratification.
  • Staging of early adenocarcinoma with endoscopic ultrasound (nodal involvement) and endoscopic resection (T classification) determines if a patient is a candidate for endoscopic therapy.
  • Endoscopic therapy includes endoscopic resection, cryotherapy and radiofrequency ablation for dysplasia and early adenocarcinoma.

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