ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Public Deposited
Analytics

Downloadable Content

Download PDF
Request Version for Screen Reader
Creator
  • Shaheen, Nicholas J.
    • School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology
  • Falk, Gary W.
    • Other Affiliation: Division of Gastroenterology; University of Pennsylvania Perelman School of Medicine
  • Iyer, Prasad G.
    • Other Affiliation: Division of Gastroenterology and Hepatology; Mayo Clinic Minnesota
  • Gerson, Lauren B.
    • Other Affiliation: Division of Gastroenterology; California Pacifi C Medical Center and Department of Medicine; University of California
Abstract
  • Barrett's esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with reflux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3-5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-definition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is also recommended for patients with BE and low-grade dysplasia, although endoscopic surveillance continues to be an acceptable alternative. Given the relatively common recurrence of BE after ablation, we suggest postablation endoscopic surveillance intervals. Although many of the recommendations provided are based on weak evidence or expert opinion, this document provides a pragmatic framework for the care of the patient with BE.
Date of publication
Keyword
DOI
Identifier
Resource type
  • Article
Rights statement
  • In Copyright
Journal title
  • The American Journal of Gastroenterology
Journal volume
  • 111
Journal issue
  • 1
Page start
  • 30
Page end
  • 50
Language
  • English
ISSN
  • 0002-9270
  • 1572-0241

Relations

Parents:

This work has no parents.

Items

Thumbnail Title Date Uploaded Visibility Actions
file details ajg2015322a.pdf 2016 Public Download