What Is Barrett's Esophagus?

Barrett’s esophagus is a condition that occurs when there is metaplastic change in the cells that line the lower part of the esophagus. The cells change from normal stratified squamous epithelium to simple columnar epithelium with some goblet cells. This transition is considered to be a premalignant change, which means there is a higher risk of cancer. This is due to the high incidence of transition to esophageal adenocarcinoma.

Barrett’s esophagus is a well-known complication of gastroesophageal reflux disease. When the lining in the esophagus is exposed for a prolonged duration to the reflux contents, it can lead to erosion of the esophageal mucosa, increase inflammatory cell infiltrate, and result in epithelial necrosis. This damage leads to the replacement of esophageal lining with metaplastic cells as seen in Barrett’s esophagus.

1. History

Barrett’s esophagus is named after Australian thoracic surgeon Norman Barrett. The definition of this condition has evolved over the last century. In 1906, it was described by a pathologist as peptic ulcer of the esophagus. Over the next four decades, the debate revolved on the anatomic origin of the mucosal anomaly. In 1950, Barrett supported the ideology that the stomach was tethered within the chest due to a congenitally short esophagus. However, in 1953, it was argued by Allison and Johnstone to be esophageal tissue and was agreed by Barrett in 1957. The histologic description for the next two decades vary and by 1976, a report on the histologic spectrum of the condition was published where biopsies were performed using manometric guidance.

What Is Barrett's Esophagus?

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