Barrett's esophagus: Definition and diagnosis

Identification of the gastroesophageal junction (GEJ) is a contentious issue that has confounded investigations on Barrett's esophagus. The majority of published studies on Barrett's esophagus conducted over the past 20 years have used the proximal extent of the gastric folds as the landmark for the GEJ and, in the absence of compelling data for the use of alternative markers, it seems reasonable to use this landmark, despite its shortcomings. The association between adenocarcinoma and Barrett's esophagus had been well established by the 1970s. By the late 1980s, it had become widely accepted that intestinal metaplasia was the epithelial type especially associated with neoplasia in Barrett's esophagus. Some clinical studies suggested that cardiac epithelium has increased malignant potential. The definition of Barrett's esophagus has undergone substantial evolution since Norman Barrett's original report in 1950.