Prevalence and modern aspects of the treatment of patients with Barrett’s esophagus

Abstract

The article analyzes the prevalence and principles in treatment of Barrett’s esophagus. The prevalence of Barrett’s esophagus varies widely from region to region of the world and has ethnic differences. The use of endoscopic methods and the histological examination of the biopsies of esophageal mucosa are of utmost importance in the diagnosis of this pathology. The prevention of esophageal cancer is the main task in managing patients with Barrett’s esophagus. The length of the Barrett’s esophagus segment, the presence and extent of dysplasia is of the greatest importance to select tactics for managing patients. Endoscopic methods are widely used for the eradication of metaplasia sites, among which the radiofrequency ablation is the most effective one. Prolonged treatment with proton pump inhibitors is safe and reduces the risk of transformation of Barrett’s esophagus into adenocarcinoma of the esophagus. There is evidence that small doses of aspirin, nonsteroidal anti-inflammatory drugs, statins and ursodeoxycholic acid have the preventive effect on the development of esophageal cancer. However, the possibilities of using these drugs for this purpose are still limited. Anti-reflux surgery still holds relevance, but at the same time, it has no advantages over the drug therapy for the prevention of esophageal cancer.