A Practical Approach to Refractory and Recurrent Barrett's Esophagus

Domenico A. Farina, Ashwinee Condon, Srinadh Komanduri, V. Raman Muthusamy*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Endoscopic eradication therapy (EET) is recommended for patients with Barrett's esophagus (BE)-associated neoplasia and is effective in achieving complete eradication of intestinal metaplasia (CE-IM). However, BE that is refractory to EET, defined as partial or no improvement in dysplasia after less than or equal to 3 ablative sessions, and the development of recurrence post-EET is not uncommon. Identification of refractory BE or recurrent intestinal metaplasia should prompt esophageal physiologic testing and modification of antireflux strategy, as appropriate. In patients who ultimately fail standard EET despite optimization of reflux control, salvage EET with alternate modalities may need to be considered.

Original languageEnglish (US)
Pages (from-to)183-203
Number of pages21
JournalGastrointestinal Endoscopy Clinics of North America
Volume31
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • Ablation
  • Barrett's esophagus
  • Dysplasia
  • Endoscopic eradication therapy
  • Recurrent disease
  • Refractory disease

ASJC Scopus subject areas

  • Gastroenterology

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