Barrett's esophagus

Winters, Charles; Spurling, Timothy J.; Chobanian, Sarkis J.; Curtis, David; Esposito, Regina L.; Hacker, Joseph; Johnson, David A.; Cruess, David F.; Cotelingam, James D.; Gurney, Michael S.; Cattau, Edward L.

doi:10.1016/0016-5085(87)90847-x

Cited by 635 publications

(29 citation statements)

References 23 publications

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“…The severity of GERD is directly correlated with the degree and duration of esophageal acid exposure and is highly pH dependent [4][5][6] . Chronic exposure is associated with serious complications including esophageal stricture in 4%-20% of patients [4] and Barrett's esophagus in up to 15% of patients with GERD [4][5][6][7] . Healing of reflux esophagitis is directly correlated with the intragastric pH > 4.0 [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

Zheng¹

2009

WJG

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AIM:To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs). METHODS:Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole (n = 68), 30 mg of lansoprazole (n = 69), 40 mg of pantoprazole (n = 69), 40 mg of esomeprazole (n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2: mild-moderate; 3: moderate; 4: moderate-severe; 5: severe). RESULTS:The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole (P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069, respectively), lansoprazole (P = 0.0020, P = 0.0046, P = 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole (P = 0.0006, P = 0.0005, P = 0.0009, P = 0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8. CONCLUSION:Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.

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Section: Introductionmentioning

confidence: 99%

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

Zheng¹

2009

WJG

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“…This metaplastic change is most likely the result of severe and longstanding esophageal reflux and carries an increased risk of developing esophageal adenocarcinoma. [1][2][3][4] Esophageal adenocarcinoma is preceded by premalignant epithelial changes, i.e., low-grade dysplasia (LGD) and high-grade dysplasia (HGD), the latter being synonymous to adenocarcinoma in situ. [5][6][7] Most commonly used ablative therapies are argon plasma coagulation and photodynamic therapy.…”

mentioning

confidence: 99%

Genomic analysis of Barrett's esophagus after ablative therapy: Persistence of genetic alterations at tumor suppressor loci

Hage

Siersema

Vissers

et al. 2005

Intl Journal of Cancer

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Barrett's esophagus (BE) is a major predisposing factor for the development of esophageal adenocarcinoma. Current strategies for treatment of BE, both dysplastic and nondysplastic, include photodynamic therapy (PDT) and argon plasma coagulation (APC). However, the effect of ablative therapy at the genetic level is unclear. We performed loss of heterozygosity (LOH) analysis of BE in baseline and follow-up biopsy specimens from 21 patients with BE (17 male, 4 female) treated with PDT and/or APC. At baseline, 14 patients had intestinal metaplasia without dysplasia (MET), 4 low-grade dysplasia (LGD) and 3 high-grade dysplasia (HGD). LOH was assessed using a panel of 9 polymorphic markers for evaluation of the P53 gene on 17p, P16 on 9p, DCC and SMAD4 on 18q and the APC gene on 5q. The tissue specimens obtained at baseline (t 5 0) were analysed, as well as the first (t 5 1; mean interval: 4 months) and last (t 5 2; mean interval: 8 months) available biopsy with residual or recurrent BE after ablation. At t 5 0, allelic loss was detected of 5q in 27%, 9p in 56%, 17p in 31% and 18q in 6% of informative cases. At t 5 1 (18 patients with persistent MET and 3 with LGD) and at t 5 2 (8 MET, 2 LGD), the LOH patterns were not statistically different from t 5 0. Further, multiple genetic lineages before and after therapy were detected in 15 cases illustrating the multiclonal nature of BE. We conclude that recurrent and/or persistent BE after ablative therapy still contains genetic alterations associated with malignant progression to cancer. Therefore, the goal of treatment should be the complete elimination of Barrett's mucosa. ' 2005 Wiley-Liss, Inc.

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“…When evaluating only those with erosive esophagitis, this rate increased to 14%. The corresponding figures from the West are 4%-20% [23,24] and 36%, respectively [23] . Reports from a Taiwanese center, and our own center showed a frequency of benign (presumably reflux-related) esophageal stricture of only 0.4% and 0.2% respectively, among patients endoscoped for various gastrointestinal indications [16,19] .…”

Section: Prevalence Of Gerd Complicationsmentioning

confidence: 99%

Gastroesophageal reflux disease is uncommon in Asia: evidence and possible explanations

Ho¹

1999

WJG

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Barrett's esophagus

Cited by 635 publications

References 23 publications

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

Genomic analysis of Barrett's esophagus after ablative therapy: Persistence of genetic alterations at tumor suppressor loci

Gastroesophageal reflux disease is uncommon in Asia: evidence and possible explanations

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