ASGE Postgraduate Course at ACG: Evidence-based Updates for the Practicing Gastroenterologist | October 2021-The Continuum of Endoscopic Care for Barrett's Esophagus

Video Transcription

Video Summary

In this video, Dr. Pooja Elias, an associate professor of medicine at the Medical University of South Carolina, discusses the continuum of endoscopic care for Barrett's esophagus. She begins by explaining that Barrett's esophagus is the replacement of normal squamous epithelium in the esophagus with metaplastic intestinal type epithelium, often caused by ongoing acid exposure from reflux. She highlights that 7-10% of patients with gastroesophageal reflux disease (GERD) will develop Barrett's esophagus. Barrett's esophagus is the only known precursor to esophageal adenocarcinoma, and the incidence of this cancer has been increasing. Dr. Elias discusses the rationale for screening and the target population for screening, which includes patients over 50 with additional risk factors such as GERD, obesity, and a family history of Barrett's esophagus or esophageal adenocarcinoma. She also discusses the diagnostic process for Barrett's esophagus, including endoscopic biopsies and various imaging techniques. Treatment options for Barrett's esophagus range from endoscopic resection to ablative therapy. Dr. Elias emphasizes the importance of resection for nodularities and the need for continued surveillance in patients who have undergone endoscopic eradication therapy. She also touches on controversies in the field, including the management of low-grade dysplasia. Dr. Elias concludes by discussing future directions in the field, such as better screening methods, chemoprevention, and the role of artificial intelligence. (Transcript summary courtesy to Dr. Pooja Elias's presentation at the ASGE course, "What to Do and When to Do It: More Than One Option for Management of Barrett's Esophagus", uploaded by American Society for Gastrointestinal Endoscopy.)

Asset Subtitle

Puja S. Elias, MD

Keywords

Barrett's esophagus

endoscopic care

acid exposure

GERD

esophageal adenocarcinoma

screening