PMID- 15478857
OWN - NLM
STAT- MEDLINE
DCOM- 20041104
LR  - 20190627
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 117 Suppl 5A
DP  - 2004 Sep 6
TI  - Barrett esophagus: will effective treatment prevent the risk of progression to 
      esophageal adenocarcinoma?
PG  - 79S-85S
AB  - Barrett esophagus is a complication of long-standing gastroesophageal reflux 
      disease (GERD) and is the well-recognized premalignant condition for the majority 
      of esophageal and gastroesophageal junction adenocarcinomas. Although duration of 
      gastroesophageal reflux (GER), male sex, and, possibly, a strong family history 
      are directly related to risk of Barrett esophagus, the role of screening in those 
      with GERD and surveillance in those with confirmed Barrett syndrome remains 
      controversial. Acid suppression with proton pump inhibitor (PPI) therapy plays a 
      pivotal role in the management of symptoms in persons with chronic GER and 
      Barrett esophagus. Although there is no conclusive evidence for the role of PPIs 
      in regression of Barrett epithelium or prevention of dysplasia, longer-term 
      studies that titrate the dose to normalization of esophageal pH may proffer 
      different data in the future. Although highly touted in the literature, surgical 
      and endoscopic ablation therapies are limited by several factors, including high 
      rates of symptom recurrence, persistently abnormal pH values, need for repeat 
      surgery, and, in the case of endoscopic therapy, residual Barrett metaplasia that 
      can progress to high-grade dysplasia or cancer. These invasive interventions 
      should only be considered after consultation with a gastroenterologist. Cancer 
      chemoprevention strategies are just emerging, and their roles as direct 
      chemoprotectants remain to be determined.
FAU - Sharma, Prateek
AU  - Sharma P
AD  - University of Kansas School of Medicine and the Veterans Administration Medical 
      Center, Kansas City, Missouri 64128, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Proton Pumps)
SB  - IM
MH  - Adenocarcinoma/mortality/pathology/*prevention & control
MH  - Barrett Esophagus/complications/drug therapy/*pathology
MH  - Esophageal Neoplasms/mortality/pathology/*prevention & control
MH  - Esophagoscopy
MH  - Female
MH  - Fundoplication
MH  - Gastroesophageal Reflux/complications/*drug therapy/surgery
MH  - Humans
MH  - Male
MH  - Mass Screening/methods
MH  - Precancerous Conditions/*pathology
MH  - Primary Prevention/methods
MH  - Prognosis
MH  - *Proton Pump Inhibitors
MH  - Proton Pumps/therapeutic use
MH  - Risk Assessment
MH  - Survival Rate
MH  - Treatment Outcome
RF  - 51
EDAT- 2004/10/14 09:00
MHDA- 2004/11/05 09:00
CRDT- 2004/10/14 09:00
PHST- 2004/10/14 09:00 [pubmed]
PHST- 2004/11/05 09:00 [medline]
PHST- 2004/10/14 09:00 [entrez]
AID - S1548-2766(04)00013-5 [pii]
AID - 10.1016/j.amjmed.2004.07.013 [doi]
PST - ppublish
SO  - Am J Med. 2004 Sep 6;117 Suppl 5A:79S-85S. doi: 10.1016/j.amjmed.2004.07.013.