Barrett's esophagus: Origin, development and options for therapeutic intervention

Barrett’s esophagus (BE) consists of a metaplasia in which the normal squamous cells lining the esophagus are replaced by a mixture of gastric and intestinal lining cells. The intestinal-type lining cells are often referred to as specialized columnar cells and include e.g. goblet cells. For a number of years, some scientists thought that there were two types of BE; one in which the normal lining was replaced with gastric type cells only, and the second in which intestinal cells were present. Presently, intestinal metaplasia is required for the diagnosis of BE because intestinal metaplasia is the only type of esophageal columnar epithelium that clearly predisposes to malignancy. BE is a complication of chronic gastroesophageal reflux disease (GERD), primarily in white men. GERD is a disease in which there is reflux of acidic fluid from the stomach and bile contents from the duodenum into the esophagus. It most commonly causes heartburn, but many patients do not have any symptoms.