Endoscopic treatment of Barrett's esophagus.

Barrett's esophagus is a complication of gastroesophageal reflux (GER) that increases the risk of adenocarcinoma of the distal esophagus. Neither antisecretory drugs nor antireflux surgery are effective in achieving reversal of the metaplasia. In contrast, physical destruction of the metaplastic mucosa (by laser coagulation, photodynamic therapy, or electrocoagulation) combined with effective anti-reflux therapy is followed by restoration of normal squamous epithelium. However,there is no conclusive evidence to date that endoscopic removal of the metaplastic mucosa is sufficient to avert cancer; Long-term longitudinal studies will have to be conducted before endoscopic therapy can be recommended for the routine treatment of Barrett's esophagus.