ASGE Masterclass: Barrett’s Esophagus, GERD and Esophageal Adenocarcinoma (Virtual) | February 2022-Looking on the way in and out: Maximize esophageal endoscopy

Video Transcription

Video Summary

In this video, Dr. Prasad Iyer discusses the optimal approach to esophageal endoscopy and highlights key considerations in maximizing the effectiveness of the procedure. He begins by emphasizing the importance of accurately assessing the esophagus, rather than solely focusing on entering the stomach. Dr. Iyer discusses various indications for performing an esophageal examination, such as assessing persistent symptoms, evaluating dysphagia accompanied by alarm symptoms, and screening for Barrett's esophagus in patients with chronic reflux symptoms and other risk factors. He provides insights into performing a high-quality endoscopy, including the importance of adequate sedation, thorough cleaning of the esophagus, and careful inspection of the mucosa. Dr. Iyer emphasizes the significance of conducting a retroflex examination and offers tips on evaluating the esophagogastric junction. He also highlights the use of the Los Angeles classification system for grading esophagitis and explains why accurately diagnosing and grading esophagitis can impact treatment decisions and follow-up recommendations. Dr. Iyer discusses the assessment of Barrett's esophagus, including the Prague classification and the importance of accurately measuring the extent of the Barrett segment. He emphasizes the need to differentiate between irregular Z-lines and true Barrett's esophagus through careful evaluation. The video also covers the assessment of hiatal hernias, the classification of anti-reflux surgeries, and the importance of assessing the upper esophageal sphincter and other findings during withdrawal. Dr. Iyer concludes by summarizing the key takeaways for a thorough esophageal examination, including proper identification and documentation of landmarks, assessment for eosinophilic esophagitis, use of the Los Angeles classification system, careful evaluation for Barrett's esophagus, inspection for visible lesions, and the importance of retroflex examination.

Keywords

esophageal endoscopy

maximizing effectiveness

Barrett's esophagus screening

high-quality endoscopy

Los Angeles classification system

Barrett's esophagus assessment

retroflex examination