How I Do It: Surveillance Endoscopy for Barrett’s Esophagus and Gastric Intestinal Metaplasia

Abstract

Barrett’s esophagus and gastric intestinal metaplasia are precancerous conditions in the upper gastrointestinal tract that are easily identifiable on endoscopy. Although most cases will never progress to cancer, these conditions warrant endoscopic surveillance to detect and treat dysplasia. The key to detecting precancerous lesions is to follow a systematic approach for a high-quality examination. Additional steps to optimize practice are to apply image enhanced endoscopy, spend adequate time inspecting, appreciate principles of optical diagnosis, recognize mucosal and vascular patterns consistent with intestinal metaplasia and dysplasia, and take targeted biopsies of abnormalities.

Can We Impact the Incidence and Outcomes of Barrett’s Esophagus and Esophageal Adenocarcinoma?

“…7 Finally, we can't over emphasize the importance of a highquality endoscopic examination and look forward to new technologies and artificial intelligence to help improve dysplasia detection in BE. 8,9 This issue also contains fantastic complementary articles on screening for foregut cancers in Lynch syndrome and surveillance after surgery. 10,11 We are pleased to publish 4 original research articles this month and 1 original review as our journal continues to grow.…”