MANAGEMENT OF BARRETT'S ESOPHAGUS - CME Conferences
MANAGEMENT OF BARRETT'S ESOPHAGUS - CME Conferences MANAGEMENT OF BARRETT'S ESOPHAGUS - CME Conferences
3 rd Annual Essentials in Primary CareSummer Conference: Session 1Thursday, July 26, 2012HIGH GRADE DYSPLASIA IN BE• Diffuse HGD: 67 patients• Focal HGD: 33 patientsAssociated with > risk of AdenoCA Relative riskExtent of HGD 5.63Nodule on endoscopy 3.98Lack of acid suppression 2.48( Buttar et al, Gastroenterology 120:1639, 2001)PPIs REDUCE INCIDENCE OF DYSPLASIA IN BE• Retrospective review of 236 VA pts with BE over20 yrs.– 56 pts developed dysplasia (4.7%/yr)• Incidence of dysplasia lower (p
3 rd Annual Essentials in Primary CareSummer Conference: Session 1Thursday, July 26, 2012HOW A COMMON HEALTH PROBLEM IS QUIETLYBECOMING AN UNSUSPECTED KILLERTara Parker-PopeThe Wall Street JournalOctober 10, 2005“Chronic heartburn can turn deadly, leading to anaggressive esophageal cancer that few survive”“Use of acid-suppressing drugs may play a rolein the rise of esophageal cancer”“An alternate to drug treatment is surgery”ANTI-REFLUX SURGERY DOES NOT REMOVERISK OF ESOPHAGEAL CANCER IN GERDsurgery no surgeryMales with GERD: 6,406 35,274AdenoCa risk:* 14.1 (CI,8-23) 6.3 (CI,4.5-8.7)“The risk of developing adenocarcinoma of theesophagus remains increased after antirefluxsurgery”* Excluded 1 st year FU(Ye, Chow, Lagergren et al: Gastroenterology 121:1296, 2001)Donald Castell, MDManagement of Barrett’s Esophagus
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3 rd Annual Essentials in Primary CareSummer Conference: Session 1Thursday, July 26, 2012HIGH GRADE DYSPLASIA IN BE• Diffuse HGD: 67 patients• Focal HGD: 33 patientsAssociated with > risk of AdenoCA Relative riskExtent of HGD 5.63Nodule on endoscopy 3.98Lack of acid suppression 2.48( Buttar et al, Gastroenterology 120:1639, 2001)PPIs REDUCE INCIDENCE <strong>OF</strong> DYSPLASIA IN BE• Retrospective review of 236 VA pts with BE over20 yrs.– 56 pts developed dysplasia (4.7%/yr)• Incidence of dysplasia lower (p
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