Year 2019 / Volume 111 / Number 10
Review
Barrett’s esophagus: “All diseases are divine and all are human”

789-794

DOI: 10.17235/reed.2019.6261/2019

Vicente Munitiz Ruiz, Luisa F. Martienz de Haro, Ángeles Ortiz, David Ruiz de Angulo, Pascual Parrilla,

Abstract
Barrett’s esophagus (BE) is a controversial condition. The significance of this condition lies in its premalignant potential, so it is important that clinically applicable biomarkers be identified for early detection and targeted prevention. Dysplasia is currently used as main biomarker, but others most recently surveyed in cancer also include microRNAs. Classically, BE was considered to be an acquired disease related to pathological gastroesophageal acid and bile reflux. However, some cases are associated with genetic predisposition, representing an inherited, familial form of BE. The actual gene, or genes, involved in this condition have not yet been identified. Main therapeutic options include medical treatment and antireflux surgery. Both types of treatment are equally efficient in controlling symptoms and neither is able to cause the metaplastic segment to disappear, which is why the risk of malignancy remains. However, we may use endoscopic radiofrequency to eradicate BE and replace it by the typical squamous epithelium of the esophagus. The currently accepted indications of radiofrequency in BE include low- and high-grade dysplasia, but not Barrett’s esophagus without dysplasia. In conclusion, BE may have two different presentations: environmental (“human”, reflux) or sporadic BE, which is the most common form, and genetic (“divine”, inherited) or familiar BE, less common but with a greater risk for malignancy. As they might be two different diseases, surveillance programs and treatments should also be different.
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Munitiz Ruiz V, Martienz de Haro L, Ortiz Á, Ruiz de Angulo D, Parrilla P. Barrett’s esophagus: “All diseases are divine and all are human”. 6261/2019


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Publication history

Received: 04/03/2019

Accepted: 15/04/2019

Online First: 25/09/2019

Published: 03/10/2019

Article revision time: 35 days

Article Online First time: 205 days

Article editing time: 213 days


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