What Constitutes Barretts Esophagus?
In the broadest definition, Barrett’s can be considered to be the replacement of any amount of the squamous epithelium of the lower esophagus with an altered columnar epithelium displaying intestinal metaplasia that has an enhanced potential for proliferation and eventual progression to dysplasia and cancer.(10) But this is too simple a definition because both the topography and the degree of the metaplasia are very important when considering its potential for progression to dysplasia and carcinoma. Intestinal metaplasia of the columnar epithelium of the stomach, whether occurring in the antrum, fundus, or cardia, is also common and does not hold the high potential for malignant change as that of intestinal metaplasia of the esophagus.(11) Typically, endoscopy reveals an irregular squamo-columnar junction with finger-like projections of salmon-pink colored columnar mucosa that has migrated up into the gray-colored squamous lining of the esophagus (Figure 1). When these projections cont
