Ali Yeğinsu1, Makbule Ergin1, Reşid Doğan Köseoğlu2, Cumhur İbrahim Başsorgun3
1Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Tokat
2Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Tokat
3Akdeniz Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Antalya
Barrett esophagus is described as a condition in which the
normal squamous epithelium of the distal esophagus is
replaced by abnormal columnar mucosa containing intestinal
metaplasia. The prevalence of gastroesophageal reflux
is 20% and Barrett esophagus is 0.4% in Turkey. Cronic
mucosa irritation related to gastroesophageal reflux is the
most important cause of the development of Barrett esophagus.
In addition, obesity and some other diseases may result
in Barrett esophagus development. Barrett esophagus is the
only known precursor to esophageal adenocarcinoma and to
date, it is one of the cancer types that has the most rapidly
increasing incidence. Carcinogenic risk is 30 times higher
than that in the normal population. Treatment should have the
purpose of controlling symptoms of gastroesophageal reflux,
preventing acid and duodenal reflux into esophagus, preventing
the development of complications, such as erosion, peptic
ulcus, stricture, preventing proximally extension of intestinal
metaplasia, inducing regression of intestinal metaplasia to
the normal mucosa, preventing the development of dysplasia,
inducing regression of dysplasia to nondysplastic cells, and
preventing the development of adenocarcinoma. The grade of
the dysplasia determines the treatment modality. Whereas in
patients with non-dysplastic or low grade dysplasia, followup,
medical treatment, antireflux surgery or ablation therapy
may be appropriate, esophagectomy should be preferred in
patients with high grade dysplasia.