Treatment of Barrett's esophagus: a narrative review

Background and Objective: Our goal is to highlight the strong correlation of Barrett's esophagus (BE) and esophageal cancer and to provide an updated review for clinicians on the various treatment options that are available. BE is an acquired condition through which most cases are secondary to the damaging effects of gastroesophageal reflux disease (GERD). Barrett's esophagus is the only recognized premalignant lesion of esophageal adenocarcinoma (EAC) and it carries an 11 -fold higher risk of EAC compared to the general population. This risk is dependent on the degree of dysplasia and therefore management focuses on treating the underlying GERD and varies based on the degree of dysplasia. Methods: Narrative review incorporated from electronic databases (including PubMed, Google Scholar, UpToDate, ScienceDirect) spanning from 1990 to 2020 sampling from multiple centers in both a generalized population as well as age and gender specific. Analysis includes multivariate, meta -analysis, retrospective, and structured questionnaires. The research designs comprise prospective and retrospective cohort studies, casecontrol, and sham -controlled trials. Key Content and Findings: This literature review contains both preventive measures and treatment strategies in the efforts to manage BE and EAC. This ranges from serial endoscopies, medical therapy including PPIs, endoscopic mucosal resection, endoscopic submucosal dissection, radiofrequency ablation, multipolar electrocoagulation, argon plasma coagulation, cryotherapy, photodynamic therapy, and esophagectomies. Certainly, there are approaches that have proven to be superior than others, but there remains rooms for improvement in order to refine our current practices. Conclusions: BE is a frequent predisposing factor implicated in the development of esophageal cancer. Over the years, there has been abundant changes in the surveillance and management of this condition. Therefore, familiarizing clinicians with the current treatment modalities of GERD and BE is fundamental in mitigating its potential to become cancer.