Debates

Gastroesophageal reflux disease (GERD) testing has evolved ever since the initial introduction of the catheter-based pH test more than half a century ago. More accurate pH measurements and improved patient tolerability were achieved by reducing the catheter’s diameter and stiffness, and the catheter-based pH test has continued to improve over the years.1 Introduction of the […]

Debates

Prolonged pH or reflux monitoring is neither essential to the primary evaluation or treatment of patients with suspected gastroesophageal reflux disease (GERD) who respond to therapy nor needed for patients who have endoscopydocumented erosive esophagitis that responds to antisecretory therapy. The history, endoscopic findings and clinical response to therapy provide adequate support for the diagnosis of GERD in […]

Debates

F or patients found to have low-grade dysplasia (LGD) in Barrett’s esophagus, two recent studies suggest that the decision between treating with radiofrequency ablation (RFA) or simply continuing endoscopic surveillance is a slam dunk for RFA.1,2 In a European, randomized trial of surveillance versus radio frequency ablation (SURF) for 136 patients who had LGD confirmed […]

Debates

The primary goal of ablation in Barrett’s esophagus is to reduce progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). The decision to perform endoscopic therapy (with the goal to eliminate intestinal metaplasia), is based on the principles of: 1. documenting an elevated risk of progression, 2. demonstrating reduction in risk of progression using robust […]

Quick Hits

Barrett’s esophagus, a precursor to esophageal adenocarcinoma, is the focus of current efforts to combat the rapidly rising incidence of this deadly cancer. Barrett’s esophagus is thought to progress from nondysplastic Barrett’s esophagus through low-grade dysplasia and high-grade dysplasia before becoming adenocarcinoma. The risk of esophageal adenocarcinoma is assessed by sampling the affected mucosa through […]

Quick Hits

We are all aware that the incidence of esophageal adenocarcinoma has been rising rapidly over the last 50 years. Since the cancer is associated with an endoscopically visible lesion in Barrett’s esophagus, screening for esophageal adenocarcinoma ought to be relatively easy compared to screening for other terrible cancers, such as pancreatic or ovarian. But there […]