The incidence of Barrett adenocarcinoma is increasing substantially and was estimated at 2.8 cases per 100 000 people in the United States in 2010.1 Given the premalignant potential of Barrett intestinal metaplasia, it would be logical to simply eliminate preneoplastic tissue. Indeed, if Barrett esophagus was a focally localized, raised, and easily recognizable lesion (ie, polyp), endoscopic removal would be a relatively easy task, and there would be no discussion about how to prevent neoplastic progression in these patients.