caa a22 4500 475791126 CHVBK 20180406123711.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s004230000160 doi (NATIONALLICENCE)springer-10.1007/s004230000160 The relationship between gastroesophageal reflux, intestinal metaplasia and adenocarcinoma of the esophagus [Elektronische Daten] [H. J. Stein, Marcus Feith, H. Feussner] Abstract.: Currently available data indicate a clear and probably causal relationship between long-lasting gastroesophageal reflux disease, the development of long segments with specialized intestinal metaplasia in the distal esophagus and subsequent progression to adenocarcinoma. To a lesser degree, this also appears to be the case for short segments of specialized intestinal metaplasia in the distal esophagus. In contrast, epidemiological data and classic parameters for the diagnosis of gastroesophageal reflux disease do not currently support a causal role of gastroesophageal reflux in the pathogenesis of specialized intestinal metaplasia at the gastric cardia. Despite its high prevalence and malignant potential, many questions about the prevention and management of intestinal metaplasia in the distal esophagus remain unsolved. In patients with chronic gastroesophageal reflux, current modes of medical therapy do not appear to prevent the development of intestinal metaplasia, while effective anti-reflux surgery seems to have a protective effect. Formal studies with adequate follow-up are, however, still lacking. Neither acid-suppression therapy nor anti-reflux surgery, with or without mucosal ablation, can reliably prevent the malignant degeneration of established intestinal metaplasia of the esophagus. Close endoscopic surveillance with extensive biopsies, therefore, remains mandatory in such patients, irrespective of the treatment modality. Springer-Verlag, 2000 Gastroesophageal reflux Barrett esophagus Intestinal metaplasia Anti-reflux surgery Barrett cancer Mucosal ablation Medical therapy Esophageal cancer nationallicence Stein H. J. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut Feith Marcus Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut Feussner H. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut https://doi.org/10.1007/s004230000160 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000160 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stein H. J. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Feith Marcus Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut NATIONALLICENCE 700 1- Feussner H. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675 München, Germany aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer