ASGE Masterclasses, facilitated by expert gastroenterologists and endoscopists, focus this program on the diagnosis and management practice trends of Barrett’s Esophagus (BE) and how the incidence of BE can lead to esophageal adenocarcinoma (EAC). 

This program begins by highlighting the prevalence of BE, providing trends on observations throughout North America and how BE is increasing as a result of gastric imbalance diseases and obesity. Europe will be highlighted with a focus on why awareness about gastric disease in this region has made BE becoming more prevalent. Asia-Pacific locations is anticipated to account for a growing area of concern for BE patient populations due to high prevalence of obesity & alcohol consumption in populated countries and rapidly improving health care infrastructures.  

It also reviews how patients often initially present themselves, usually to their primary care physician, with complaints of frequent heartburn, difficulty swallowing food and at times chest pain. When assessed GI is consulted, will review endoscopic landmarks for BE diagnosis with attention to newer technologies that have been developed to make palisade vessels more visible including how narrow band imaging (NBI) is becoming more promising as a possible technique.  Faculty go in-depth, comparing and contrasting the three main ablation techniques used for BE: radiofrequency ablation (RFA), argon plasma coagulation (APC) and cryotherapy.  Because BE is associated with chronic gastroesophageal reflux disease (GERD), the high incidence of reflux esophagitis, prompted by the decrease in Helicobacter pylori infection and the increase in obesity, can lead to BE.  A review of antisecretory therapy with proton pump inhibitors (PPIs) or elimination of reflux with anti-reflux surgery will also be discussed. 

Faculty conclude this program with projected approaches and predicted incidence of BE in the near future and how gastroenterologists and endoscopists must address this patient population going forward. 

• Review geographical prevalence of Barrett’s esophagus and why (comprehension).
• Summarize the current endoscopic and medical therapeutic options for managing the patient with Barrett's esophagus (knowledge).
• Describe the association between H pylori infection and development of gastroesophageal reflux disease (knowledge).
• Select key innovations in the endoscopic management of gastroesophageal reflux disease (analysis).

Prashanthi N Thota, MD, FASGE
Cleveland Clinic
Cleveland, Ohio, USA

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