Today's Toolbox for Barrett's Endotherapy

Abstract

Barrett's esophagus (BE) is characterized by the metaplastic transformation of the normal squamous epithelium of the distal esophagus to columnar-lined mucosa with intestinal metaplasia. BE is the only known precursor to esophageal adenocarcinoma (EAC). Given the rising incidence of EAC in recent decades, early detection, enrollment in surveillance programs, and effective treatment are critical. BE-related neoplasia and select early esophageal cancers should be treated with endoscopic eradication therapy (EET). The toolbox for BE endotherapy has grown tremendously alongside evolving techniques in resection and new ablative devices. The success of EET hinges on thoughtful patient selection, appropriate choice of therapeutic modality, and adherence to surveillance intervals including ongoing surveillance after BE eradication. We emphasize the importance of reflux optimization and the role of patient education and counseling throughout the process.