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Historical Perspective: Evolution of the Diagnosis and Management of Barrett’s Esophagus

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Abstract

The history of Barrett’s esophagus provides insight into current understanding not only of esophageal cancer but also of the anatomy and physiology of hiatal hernia and GERD. A current definition of Barrett’s esophagus is “the condition in which metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus and predisposes to cancer development.” Although straightforward, the definition of and ability to precisely identify the esophagogastric junction and agreement on what constitutes metaplastic epithelium that predispose to cancer development remain problematic. Barrett’s esophagus is characterized by a metaplastic epithelium in the distal esophagus which may (or may not) be visualized as columnar epithelium during flexible endoscopy. To understand the history, definition, and current controversies surrounding Barrett’s esophagus requires an understanding of what defines the gastroesophageal junction and the various histologies present in this region.

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References

  1. Allison PR. Peptic ulcer of the oesophagus. Thorax. 1948;3:20–42.

    Article  CAS  Google Scholar 

  2. Allison PR, Johnstone AS. The oesophagus lined with gastric mucous membrane. Thorax. 1953;8:87–101.

    Article  CAS  Google Scholar 

  3. Barrett NR. Chronic peptic ulcer of the oesophagus and ‘oesophagitis’. Br J Surg. 1950;38:175–82.

    Article  CAS  Google Scholar 

  4. Barrett NR. The lower esophagus lined by columnar epithelium. Surgery. 1957;41:881–94.

    CAS  PubMed  Google Scholar 

  5. Belladonna JA, Hajdu SI, Bains MS, Winawer SJ. Adenocarcinoma in situ of Barrett’s esophagus diagnosed by endoscopic cytology. N Engl J Med. 1974;291:895–6.

    Article  CAS  Google Scholar 

  6. Bosher LH, Taylor FH. Heterotopic gastric mucosa in the esophagus with ulceration and stricture formation. J Thorac Surg. 1951;21:306–12.

    CAS  PubMed  Google Scholar 

  7. Brandt LJ, Kauvar DR. Laser-induced transient regression of Barrett’s epithelium. Gastrointest Endosc. 1992;38:619–22.

    Article  CAS  Google Scholar 

  8. Bremner CG, Lynch VP, Ellis FH Jr. Barrett’s esophagus: congenital or acquired? An experimental study of esophageal mucosal regeneration in the dog. Surgery. 1970;68:209–16.

    CAS  PubMed  Google Scholar 

  9. Chandrasoma P. Pathophysiology of Barrett’s esophagus. Semin Thorac Cardiovasc Surg. 1997;9:270–8.

    CAS  PubMed  Google Scholar 

  10. Chandrasoma PD, Demeester TR. GERD: Reflux to Adenocarcinoma. Amsterdam: Elsevier; 2006.

    Google Scholar 

  11. Chandrasoma PT, Lokuhetty DM, Demeester TR, Bremmer CG, Peters JH, Oberg S, Groshen S. Definition of histopathologic changes in gastroesophageal reflux disease. Am J Surg Pathol. 2000;24:344–51.

    Article  CAS  Google Scholar 

  12. Clark GW, Ireland AP, Peters JH, Chandrasoma P, Demeester TR, Bremner CG. Short-segment Barrett’s esophagus: a prevalent complication of gastroesophageal reflux disease with malignant potential. J Gastrointest Surg. 1997;1:113–22.

    Article  CAS  Google Scholar 

  13. Clark GW, Smyrk TC, Burdiles P, Hoeft SF, Peters JH, Kiyabu M, Hinder RA, Bremner CG, Demeester TR. Is Barrett’s metaplasia the source of adenocarcinomas of the cardia? Arch Surg. 1994;129:609–14.

    Article  CAS  Google Scholar 

  14. Fitzgerald RC, di Pietro M, Ragunath K, Ang Y, Kang JY, Watson P, Trudgill N, Patel P, Kaye PV, Sanders S, O’donovan M, Bird-Lieberman E, Bhandari P, Jankowski JA, Attwood S, Parsons SL, Loft D, Lagergren J, Moayyedi P, Lyratzopoulos G, de Caestecker J, British Society of Gastroenterology. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63:7–42.

    Article  Google Scholar 

  15. Hahn HP, Blount PL, Ayub K, Das KM, Souza R, Spechler S, Odze RD. Intestinal differentiation in metaplastic, nongoblet columnar epithelium in the esophagus. Am J Surg Pathol. 2009;33:1006–15.

    Article  Google Scholar 

  16. Hankins JR, Cole FN, Attar S, Frost JL, McLaughlin JS. Adenocarcinoma involving the esophagus. J Thorac Cardiovasc Surg. 1974;68:148–58.

    CAS  PubMed  Google Scholar 

  17. Hayward J. The lower end of the oesophagus. Thorax. 1961;16:36–41.

    Article  CAS  Google Scholar 

  18. Jankowski JA, Wright NA, Meltzer SJ, Triadafilopoulos G, Geboes K, Casson AG, Kerr D, Young LS. Molecular evolution of the metaplasia-dysplasia-adenocarcinoma sequence in the esophagus. Am J Pathol. 1999;154:965–73.

    Article  CAS  Google Scholar 

  19. Liu W, Hahn H, Odze RD, Goyal RK. Metaplastic esophageal columnar epithelium without goblet cells shows DNA content abnormalities similar to goblet cell-containing epithelium. Am J Gastroenterol. 2009;104:816–24.

    Article  CAS  Google Scholar 

  20. Lord RV. Norman Barrett, “doyen of esophageal surgery”. Ann Surg. 1999;229:428–39.

    Article  CAS  Google Scholar 

  21. McClave SA, Boyce HW Jr, Gottfried MR. Early diagnosis of columnar-lined esophagus: a new endoscopic diagnostic criterion. Gastrointest Endosc. 1987;33:413–6.

    Article  CAS  Google Scholar 

  22. Miehlke S, Morgner A, Aust D, Madisch A, Vieth M, Baretton G. Combined use of narrow-band imaging magnification endoscopy and miniprobe confocal laser microscopy in neoplastic Barrett’s esophagus. Endoscopy. 2007;39(Suppl 1):E316.

    Article  Google Scholar 

  23. Morson BC, Belcher JR. Adenocarcinoma of the oesophagus and ectopic gastric mucosa. Br J Cancer. 1952;6:127–30.

    Article  CAS  Google Scholar 

  24. Murphy SJ, Johnston BT, Murray LJ. British Society of Gastroenterology guidelines for the diagnosis of Barrett’s oesophagus: are we casting the net too wide? Gut. 2006;55:1821–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Nandurkar S, Talley NJ, Martin CJ, Ng TH, Adams S. Short segment Barrett’s oesophagus: prevalence, diagnosis and associations. Gut. 1997;40:710–5.

    Article  CAS  Google Scholar 

  26. Oberg S, Clark GW, Demeester TR. Barrett’s esophagus. Update of pathophysiology and management. Hepato-Gastroenterology. 1998;45:1348–56.

    CAS  PubMed  Google Scholar 

  27. Overholt BF, Wang KK, Burdick JS, Lightdale CJ, Kimmey M, Nava HR, Sivak MV Jr, Nishioka N, Barr H, Marcon N, Pedrosa M, Bronner MP, Grace M, Depot M, International Photodynamic Group for High-Grade Dysplasia In Barrett’s Esophagus. Five-year efficacy and safety of photodynamic therapy with Photofrin in Barrett’s high-grade dysplasia. Gastrointest Endosc. 2007;66:460–8.

    Article  Google Scholar 

  28. Owen DA. Stomach. In: Sternberg SS, editor. Histology for pathologists. 2nd ed. Philadelphia: Lippincott-Raven Publishers; 1997.

    Google Scholar 

  29. Paull A, Trier JS, Dalton MD, Camp RC, Loeb P, Goyal RK. The histologic spectrum of Barrett’s esophagus. N Engl J Med. 1976;295:476–80.

    Article  CAS  Google Scholar 

  30. Reid BJ. Barrett’s esophagus and esophageal adenocarcinoma. Gastroenterol Clin N Am. 1991;20:817–34.

    CAS  Google Scholar 

  31. Rex DK, Cummings OW, Shaw M, Cumings MD, Wong RK, Vasudeva RS, Dunne D, Rahmani EY, Helper DJ. Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn. Gastroenterology. 2003;125:1670–7.

    Article  Google Scholar 

  32. Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling-Sternevald E, Vieth M, Stolte M, Talley NJ, Agreus L. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–31.

    Article  Google Scholar 

  33. Sampliner RE, Fennerty B, Garewal HS. Reversal of Barrett’s esophagus with acid suppression and multipolar electrocoagulation: preliminary results. Gastrointest Endosc. 1996;44:532–5.

    Article  CAS  Google Scholar 

  34. Sampliner RE, Hixson LJ, Fennerty MB, Garewal HS. Regression of Barrett’s esophagus by laser ablation in an anacid environment. Dig Dis Sci. 1993;38:365–8.

    Article  CAS  Google Scholar 

  35. Seery JP. Stem cells of the oesophageal epithelium. J Cell Sci. 2002;115:1783–9.

    PubMed  Google Scholar 

  36. Shaheen NJ, Richter JE. Barrett’s oesophagus. Lancet. 2009;373:850–61.

    Article  CAS  Google Scholar 

  37. Shaheen NJ, Sharma P, Overholt BF, Wolfsen HC, Sampliner RE, Wang KK, Galanko JA, Bronner MP, Goldblum JR, Bennett AE, Jobe BA, Eisen GM, Fennerty MB, Hunter JG, Fleischer DE, Sharma VK, Hawes RH, Hoffman BJ, Rothstein RI, Gordon SR, Mashimo H, Chang KJ, Muthusamy VR, Edmundowicz SA, Spechler SJ, Siddiqui AA, Souza RF, Infantolino A, Falk GW, Kimmey MB, Madanick RD, Chak A, Lightdale CJ. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360:2277–88.

    Article  CAS  Google Scholar 

  38. Sharma P. Recent advances in Barrett’s esophagus: short-segment Barrett’s esophagus and cardia intestinal metaplasia. Semin Gastrointest Dis. 1999;10:93–102.

    CAS  PubMed  Google Scholar 

  39. Sharma P, McQuaid K, Dent J, Fennerty MB, Sampliner R, Spechler S, Cameron A, Corley D, Falk G, Goldblum J, Hunter J, Jankowski J, Lundell L, Reid B, Shaheen NJ, Sonnenberg A, Wang K, Weinstein W, AGA Chicago Workshop. A critical review of the diagnosis and management of Barrett’s esophagus: the AGA Chicago Workshop. Gastroenterology. 2004;127:310–30.

    Article  Google Scholar 

  40. Sharma P, Morales TG, Bhattacharyya A, Garewal HS, Sampliner RE. Dysplasia in short-segment Barrett’s esophagus: a prospective 3-year follow-up. Am J Gastroenterol. 1997;92:2012–6.

    CAS  PubMed  Google Scholar 

  41. Skinner DB, Walther BC, Riddell RH, Schmidt H, Iascone C, Demeester TR. Barrett’s esophagus. Comparison of benign and malignant cases. Ann Surg. 1983;198:554–65.

    Article  CAS  Google Scholar 

  42. Spechler SJ, Fitzgerald RC, Prasad GA, Wang KK. History, molecular mechanisms, and endoscopic treatment of Barrett’s esophagus. Gastroenterology. 2010;138:854–69.

    Article  Google Scholar 

  43. Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ, American Gastroenterological, Association. American Gastroenterological Association technical review on the management of Barrett’s esophagus. Gastroenterology. 2011;140:e18–52; quiz e13.

    Article  Google Scholar 

  44. Spechler SJ, Zeroogian JM, Antonioli DA, Wang HH, Goyal RK. Prevalence of metaplasia at the gastro-oesophageal junction. Lancet. 1994;344:1533–6.

    Article  CAS  Google Scholar 

  45. Stein HJ, von Rahden BH, Hofler H, Siewert JR. Carcinoma of the oesophagogastric junction and Barrett’s esophagus: an almost clear oncologic model? Chirurg. 2003;74:703–8.

    Article  CAS  Google Scholar 

  46. Takubo K, Aida J, Naomoto Y, Sawabe M, Arai T, Shiraishi H, Matsuura M, Ell C, May A, Pech O, Stolte M, Vieth M. Cardiac rather than intestinal-type background in endoscopic resection specimens of minute Barrett adenocarcinoma. Hum Pathol. 2009;40:65–74.

    Article  Google Scholar 

  47. Tileston W. Peptic ulcer of the oesophagus. Am J Med Sci. 1906;132:240–65.

    Article  Google Scholar 

  48. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–20; quiz 1943

    Article  Google Scholar 

  49. Wang KK, Sampliner RE, Practice Parameters Committee of the American College of Gastroenterology. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol. 2008;103:788–97.

    Article  Google Scholar 

  50. Weston AP, Krmpotich P, Makdisi WF, Cherian R, Dixon A, McGregor DH, Banerjee SK. Short segment Barrett’s esophagus: clinical and histological features, associated endoscopic findings, and association with gastric intestinal metaplasia. Am J Gastroenterol. 1996;91:981–6.

    CAS  PubMed  Google Scholar 

  51. Weston AP, Krmpotich PT, Cherian R, Dixon A, Topalosvki M. Prospective long-term endoscopic and histological follow-up of short segment Barrett’s esophagus: comparison with traditional long segment Barrett’s esophagus. Am J Gastroenterol. 1997;92:407–13.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Esophageal and Reflux Surgery, 499 E Hampden Ave., Suite 400, Englewood, 80113, CO, USA

    Reginald C. W. Bell

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  1. Reginald C. W. Bell
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Correspondence to Reginald C. W. Bell .

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Editors and Affiliations

  1. University of Alabama at Birmingham , Birmingham, AL, USA

    Jayleen Grams

  2. The Ohio State University, Columbus, OH, USA

    Kyle A. Perry

  3. Brigham and Women’s Hospital, Boston, MA, USA

    Ali Tavakkoli

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Bell, R.C.W. (2019). Historical Perspective: Evolution of the Diagnosis and Management of Barrett’s Esophagus. In: Grams, J., Perry, K., Tavakkoli, A. (eds) The SAGES Manual of Foregut Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96122-4_25

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  • DOI: https://doi.org/10.1007/978-3-319-96122-4_25

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