MANAGEMENT OF BARRETT'S ESOPHAGUS - CME Conferences

3 rd Annual Essentials in Primary CareSummer Conference: Session 1Thursday, July 26, 2012PRIOR ACID SUPPRESSION THERAPYRELATED TO SHORTER BARRETT’S• Retrospective analysis of 340 BE patients– Diagnosis made between 1981-2000• Mean length of BE at initial Dx: 4.4 cm (range: 0.5-16)– 201(59%) no prior Rx: 4.8 cm– 63(19%) H2RA only: 4.6 cm p=0.55– 35(10%) PPI only: 3.4 cm p=0.0013– 41(12%) both PPI & H2RA: 3.1 cm p=0.002• Conclusions:– Provides a rationale for aggressive therapy of GERD– Counters the concept that antisecretory therapyincreases risk of esophageal adenocarcinoma(El-Serag et al(Sampliner): Aliment Pharmacol Ther 2004; 19: 1255)NORMALIZATION OF INTESTINALMETAPLASIA WITH ACID CONTROLN = 101; average FU = 4 yrsDysplasia or cancer: 13% LSBE; 3% SSBE; 0% EGJSIM(Horwhat et al: Am J Gastroenterol 2007; 102: 497)Donald Castell, MDManagement of Barrett’s Esophagus