Barrett's esophagus (BE) is a condition characterized by columnar mucosa replacing the normal stratified squamous mucosal lining of the esophagus. The columnar mucosa is thought to be acquired after injury to the squamous mucosa by gastroesophageal reflux (GER) and perhaps duodenogastric reflux as well.1 Barrett's esophagus is recognized to be a precursor lesion of esophageal adenocarcinoma.2 Heartburn, the symptom heralding GER, has been recognized to occur frequently in apparently normal individuals who have not sought medical attention.3 Does every patient with chronic heartburn need to be evaluated for the presence of BE? To satisfactorily answer this question, we need more information about the frequency of BE in patients with chronic GER, the natural history of BE, and the risk of developing adenocarcinoma of the esophagus in patients with BE.
The frequency of BE in patients with GER reported in the literature ranges from 3.5% to 16%.2,4