ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

@article{Shaheen2016ACGCG,
  title={ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus},
  author={N. Shaheen and G. Falk and P. Iyer and L. Gerson},
  journal={The American Journal of Gastroenterology},
  year={2016},
  volume={111},
  pages={30-50}
}
Barrett’s esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with reflux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with… Expand
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References

SHOWING 1-10 OF 227 REFERENCES
Barrett's Esophagus on Repeat Endoscopy: Should We Look More Than Once?
TLDR
Repeat EGD for Barrett's screening should not be performed out of concern for a missed diagnosis except when BE may have been obscured by overlying esophageal inflammation, except in patients with esophagitis on the first endoscopy. Expand
Barrett's Esophagus Is Common in Older Men and Women Undergoing Screening Colonoscopy Regardless of Reflux Symptoms
TLDR
BE is common in unscreened male and female patients at least 65 yr of age who are referred for colonoscopy and men were more likely than women to have BE although it occurred in both sexes. Expand
Updated Guidelines 2008 for the Diagnosis, Surveillance and Therapy of Barrett's Esophagus
TLDR
The guidelines for the diagnosis, surveillance and therapy of Barrett’s esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002 and once again reviewed using the National Library of Medicine database. Expand
Risk factors for Barrett's esophagus in community-based practice. GORGE consortium. Gastroenterology Outcomes Research Group in Endoscopy.
TLDR
Prevalence of BE is strongly associated with duration of GER symptoms, and a history of esophagitis was not an independent risk factor for BE. Expand
Predictors for Neoplastic Progression in Patients With Barrett's Esophagus: A Prospective Cohort Study
TLDR
In patients with Barrett's esophagus, the risk of developing HGD or EAC is predominantly determined by the presence of LGD, a known duration of BE of ≥10 years, longer length of BE, and presence of esophagitis. Expand
Barrett's esophagus is frequently overdiagnosed in clinical practice: results of the Barrett's Esophagus Endoscopic Revision (BEER) study.
TLDR
Be is overdiagnosed in clinical practice with important implications for patient care including increased costs, reduced insurability, and psychological stress, and the need for a better definition of the gastroesophageal junction, stricter accountability for BE diagnosis, and improved endoscopic education. Expand
Patients with nondysplastic Barrett's esophagus have low risks for developing dysplasia or esophageal adenocarcinoma.
  • S. Wani, G. Falk, +19 authors Prateek Sharma
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2011
TLDR
There is a lower incidence of dysplasia and EAC among patients with NDBE than previously reported and the length of the BE was associated significantly with progression, especially for patients with shorter segments of BE. Expand
Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States.
  • J. Abrams, R. Kapel, +4 authors C. Lightdale
  • Medicine
  • Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2009
TLDR
Adherence to BE biopsy guidelines in the community is low, and nonadherence is associated with significantly decreased dysplasia detection, according to a national community-based pathology database. Expand
Prevalence of Barrett's esophagus in asymptomatic individuals.
TLDR
Patients with BE were no more likely to be obese, consumers of tobacco or alcohol, report a family history of GERD, show association with toxic exposure, or use antacids more than once a month, compared with those without BE. Expand
Low-Grade Dysplasia in Barrett's Esophagus: Overdiagnosed and Underestimated
TLDR
LGD in BE is an overdiagnosed and yet underestimated entity in general practice and patients diagnosed with LGD should undergo an expert pathology review to purify this group. Expand
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