0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Crossroads | Clinician's Corner

A 59-Year-Old Woman With Gastroesophageal Reflux Disease and Barrett Esophagus

Stuart Jon Spechler, MD, Discussant
JAMA. 2003;289(4):466-475. doi:10.1001/jama.289.4.466.
Text Size: A A A
Published online

Extract

DR BURNS: Mrs J is a 59-year-old woman with a long history of gastroesophageal reflux disease (GERD) and documented Barrett esophagus. She lives near Boston with her husband and has 2 grown children. She sees her primary care physician, Dr W, and she has managed care insurance.

Mrs J initially developed symptoms of heartburn in the early 1990s and was prescribed ranitidine, 150 mg/d, which was later increased to twice daily without improvement. In 1993, Mrs J underwent an upper GI series, the results of which were normal; in 1994, test results for Helicobacter pylori were negative.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Figure 1. Endoscopic View of Barrett Esophagus
Graphic Jump Location
Note the red, metaplastic epithelium extending well above the gastroesophageal junction.
Figure 2. Low-Grade Dysplasia in Barrett Esophagus
Graphic Jump Location
The nuclei of the dysplastic cells are enlarged, hyperchromatic, and crowded, and these changes involve the surface cells as well as the cells of the glands. The abnormal cells remain confined within the basement membrane of their glands (hematoxylin-eosin, original magnification × 25). Photomicrograph provided by Edward Lee, MD.

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Response

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 4

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();