Sa1857 Risk Factors for Progression of Barrett's Esophagus Among the Veterans of Veterans Integrated Service Network 2

2014 ◽  
Vol 146 (5) ◽  
pp. S-313-S-314
Author(s):  
Christopher Ashley ◽  
Zachary Feinberg
2021 ◽  
Vol 1 (1) ◽  
pp. 50-62
Author(s):  
Carmelo Scarpignato ◽  
David H. Wang

Gastro-esophageal reflux disease (GERD) and Barrett’s esophagus are risk factors for esophageal adenocarcinoma (EAC). Chemoprevention is an attractive strategy, more effective than identifying early disease. Since acid reflux can lead to increased cell proliferation, decreased apoptosis, production of reactive oxygen species, DNA damage, and esophageal production of proinflammatory and pro-proliferative cytokines, proton pump inhibitors (PPIs) alone, or in combination with COX-inhibition, are the most suitable chemopreventive agents. Other compounds (statins, metformin, and selected nutraceuticals) cannot currently be recommended. Data are strong enough to warrant PPI treatment of virtually all patients with Barrett’s esophagus, although the best regimen has not yet been defined.


2020 ◽  
Author(s):  
Christopher Toivonen ◽  
Sirish Rao ◽  
Yazan Addasi ◽  
Ryan W. Walters ◽  
Kalyana Nandipati ◽  
...  

Author(s):  
K Y Song ◽  
A J Henn ◽  
A A Gravely ◽  
H Mesa ◽  
S Sultan ◽  
...  

SUMMARY Patients with Barrett's esophagus (BE) and low-grade dysplasia (LGD) are at increased risk of esophageal adenocarcinoma (EAC), although many regress to nondysplastic BE. This has significant clinical importance for patients being considered for endoscopic eradication therapy. Our aim is to determine the risk for progression in patients with confirmed persistent LGD. We performed a single-center retrospective cohort study of patients with BE and confirmed LGD between 2006 and 2016. Confirmed LGD was defined as LGD diagnosed by consensus conference with an expert GI pathologist or review by an expert GI pathologist and persistence as LGD present on subsequent endoscopic biopsy. The primary outcome was the incidence rate of HGD (high-grade dysplasia)/EAC. Secondary outcomes included risk factors for dysplastic progression. Risk factors for progression were assessed using univariate and multivariate analysis with logistic regression. Of 69 patients (mean age 65.2 years) with confirmed LGD were included. In total, 16 of 69 patients (23.2%) with LGD developed HGD/EAC during a median follow-up of 3.74 years (IQR, 1.24–5.45). For persistent confirmed LGD, the rate was 6.44 (95% confidence interval (CI), 2.61–13.40) compared to 2.61 cases per 100 patient-years (95% CI, 0.83–6.30) for nonpersistent LGD. Persistent LGD was found in only 29% of patients. Persistent LGD was an independent risk factor for the development of HGD/EAC (OR 4.18; [95% CI, 1.03–17.1]). Persistent confirmed LGD, present in only 1/3 of patients, was an independent risk factor for the development of HGD/EAC. Persistence LGD may be useful in decision making regarding the management of BE.


2006 ◽  
Vol 41 (8) ◽  
pp. 873-879 ◽  
Author(s):  
Yuji Amano ◽  
Yoshinori Kushiyama ◽  
Takafumi Yuki ◽  
Yoshiko Takahashi ◽  
Ichiro Moriyama ◽  
...  

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