Author Affiliations: Dr Spechler is Chief, Division of Gastroenterology, Dallas Veterans Affairs Medical Center, and Professor of Medicine and Berta M. and Cecil O. Patterson Chair in Gastroenterology, The University of Texas Southwestern Medical Center at Dallas.
Clinical Crossroads Section Editor: Margaret
A. Winker, MD, Deputy Editor.
DR BURNS: Mrs J is a 59-year-old woman with
a long history of gastroesophageal reflux disease (GERD) and documented Barrett
esophagus. She lives near Boston with her husband and has 2 grown children.
She sees her primary care physician, Dr W, and she has managed care insurance.
Mrs J initially developed symptoms of heartburn in the early 1990s and
was prescribed ranitidine, 150 mg/d, which was later increased to twice daily
without improvement. In 1993, Mrs J underwent an upper GI series, the results
of which were normal; in 1994, test results for Helicobacter
pylori were negative.
Spechler SJ. A 59-Year-Old Woman With Gastroesophageal Reflux Disease and Barrett Esophagus. JAMA. 2003;289(4):466-475. doi:10.1001/jama.289.4.466