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The incidence of Barrett’s metaplasia(BM)as well asBarrett’s adenocarcinoma(BA)has been increasing inwestern populations.The prognosis of BA is worsebecause individuals present at a late stage.Attempts havebeen made to intervene at early stage using surveillanceprogrammes,although proof of efficacy of endoscopicsurveillance is lacking,particularly outside the specialistcentres.The management of BM needs to be evidence-based as there is a lack clarity about how best to treat thiscondition.The role of proton pump inhibitors andantireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux earlyin the disease alters the natural history of Barrett’schange once it has developed and or prevents it inpatients with gestroesophageal reflux disease but with noBarrett’s change remains unanswered.There is much tobe learned about BM.Thus there is great need forcarefully designed large randomised controlled trials toaddress these issues in order to determine how best tomanage patients with BM.
The incidence of Barrett’s metaplasia (BM) as well as Barrett’s adenocarcinoma (BA) has been increasing inwestern populations. The prognosis of BA is worsebecause individuals present at a late stage. Attempts havebeen made to intervene at early stage using surveillance programs, Although Proof of efficacy endoscopicsurveillance is lacking, particularly outside the specialistcentres. the management of BM needs to be evidence-based as there is lack of clarity about how best to treat thiscondition. The role of proton pump inhibitors andantireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux earlyin the disease alters the natural history of Barrett’schange once it has developed and or prevents it inpatients with gestroesophageal reflux disease but with no Barrett’s change remains unanswered.There is much tobe learned about BM.Thus there is great need forcarefully designed large enough randomized controlled trials toaddress these issues in order to det ermine how best tomanage patients with BM.