Barrett's oesophagus: the continuing conundrum

doi:10.1136/bmj.321.7271.1238

BMJ 2000;321:1238-1239 ( 18 November )

Editorials

Barrett's oesophagus: the continuing conundrum

Surveillance should be confined to the surgically fit

papers p 1252

The first 150 words of the full text of this article appear below.

In 1950 Barrett wrote a treatise to clarify confusion over oesophagitis which "connote[s] one thing to some people and somethingquite different to others."¹ He described gastric mucosa extendinginto the tubular oesophagus as the result of a congenitally shortenedoesophagus. The presence of columnar lined epithelium in the oesophagusis now referred to as Barrett's oesophagus. It is associated withchronic gastro-oesophageal reflux disease and an increased riskof oesophageal adenocarcinoma.² Quantifying this risk, andthe best methods for early diagnosis, are still the subjects ofconsiderabledebate.

Endoscopically the distal end of the pearly white oesophagus is readily distinguished from the salmon red of the proximalstomach: the so called "Z line" or squamocolumnar junction. However,the location of the Z line may be difficult to identify in casesof intense inflammation, hiatal hernia, and stricture patientswith oesophagitis. Extension of the Z line proximally $---$ representingcolumnar replacement of . . . [Full text of this article]

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Final results from 10 year cohort of patients undergoing surveillance for Barrett's oesophagus: observational study: Christopher E Macdonald, Anthony C Wicks, and Raymond J Playford
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Anderson, L A, Murray, L J, Murphy, S J, Fitzpatrick, D A, Johnston, B T, Watson, R G P, McCarron, P, Gavin, A T (2003). Mortality in Barrett's oesophagus: results from a population based study. Gut 52: 1081-1084 [Abstract] [Full text]
Basu, K K, de Caestecker, J S (2002). Surveillance in Barrett's oesophagus: a personal view. Postgrad. Med. J. 78: 263-268 [Abstract] [Full text]
Eksteen, J A, Jankowski, J. A, Wild, C. P., Forman, D., Carr, R. A, Beales, I. L P, Playford, R J, Wicks, A C B, Macdonald, C E (2001). Surveillance for Barrett's oesophagus. BMJ 322: 1124-1124 [Full text]
(2001). How Intense Does Barrett's Surveillance Need to Be?. JWatch General 2001: 1-1 [Full text]

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