An update on strategies for eradication of Barrett’s mucosa

Barrett’s esophagus is a complication of chronic gastroesophageal reflux disease and is characterized by replacement of the normal squamous mucosa in the distal esophagus with metaplastic columnar mucosa. It is the premalignant lesion for adenocarcinoma of the distal esophagus and the esophagogastric junction. Treatment of Barrett’s esophagus includes controlling the underlying reflux with either proton pump inhibitor therapy or antireflux surgery. However, neither pharmacological nor surgical treatment has resulted in reversal of the metaplastic mucosa. Failure of conventional treatments has led to endoscopic ablation therapies—injury to the Barrett’s esophagus with different forms of energy in combination with acid suppression. This article reviews the current status of different therapies for endoscopic reversal of Barrett’s esophagus.