In October 2002, at Medicine Grand Rounds, Stuart Spechler, MD, discussed care for a 59-year-old woman with gastroesophageal reflux disease (GERD) and Barrett esophagus.1 Mrs J had a long history of GERD and documented Barrett esophagus. At that time her symptoms were well controlled with omeprazole (20 mg/d) and she was undergoing yearly endoscopy for surveillance. Mrs J and her physician wondered whether she needed yearly endoscopy or whether her risk of esophageal cancer is lessening given a series of recent endoscopies without evidence of dysplasia on biopsy. Dr Spechler discussed the epidemiology, initial evaluation, and medical and surgical treatment of GERD. He also reviewed management recommendations for patients with Barrett esophagus. He recommended that Mrs J continue indefinitely with coventional-dose proton pump inhibitor therapy that has controlled her GERD symptoms. He reassured her that her risk of developing esophageal cancer is small, no more than 0.5% per year. Nevertheless, he did recommend continued regular endoscopic surveillance at an interval of every 3 years.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.