The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts ha...The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts have been made to intervene at early stage using surveillance programmes, although proof of efficacy of endoscopic surveillance is lacking, particularly outside the specialist centres. The management of BM needs to be evidencebased as there is a lack clarity about how best to treat this condition. The role of proton pump inhibitors and antireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux early in the disease alters the natural history of Barrett' s change once it has developed and or prevents it in patients with gastroesophageal reflux disease but with no Barrett' s change remains unanswered. There is much to be learned about BM. Thus there is great need for carefully designed large randomised controlled trials to address these issues in order to determine how best to manage patients with BM.展开更多
大多数消化性溃疡是由于幽门螺杆菌(Helicobacter pylori,Hp)的慢性感染所致,抗生素治疗通常能够同时抗 Hp 和治愈溃疡病。然而,在过去几十年里,顽固性溃疡病常需要外科治疗,包括迷走神经切断术和胃部分切除术,前者仅缓解症状,后者既切...大多数消化性溃疡是由于幽门螺杆菌(Helicobacter pylori,Hp)的慢性感染所致,抗生素治疗通常能够同时抗 Hp 和治愈溃疡病。然而,在过去几十年里,顽固性溃疡病常需要外科治疗,包括迷走神经切断术和胃部分切除术,前者仅缓解症状,后者既切除了溃疡也切除了 Hp 的感染部位。展开更多
基金the Cancer Research Campaign,Imperial Cancer Research Fund and Medical Research Council.
文摘The incidence of Barretts metaplasia (BM) as well as Barrett' s adenocarcinoma (BA) has been increasing in western populations. The prognosis of BA is worse because individuals present at a late stage. Attempts have been made to intervene at early stage using surveillance programmes, although proof of efficacy of endoscopic surveillance is lacking, particularly outside the specialist centres. The management of BM needs to be evidencebased as there is a lack clarity about how best to treat this condition. The role of proton pump inhibitors and antireflux surgery to control reflux symptoms is justified.Whether adequate control of gastroesophageal reflux early in the disease alters the natural history of Barrett' s change once it has developed and or prevents it in patients with gastroesophageal reflux disease but with no Barrett' s change remains unanswered. There is much to be learned about BM. Thus there is great need for carefully designed large randomised controlled trials to address these issues in order to determine how best to manage patients with BM.
