Barrett's Flashcards
Suggest a diagnosis of BE require finding of intestinal metaplasia in the tubular esophagus
conditional, very low evidence
Suggest columnar mucosa of at least 1cm in length be necessary for diagnosis of BE
a) Patients w/ normal Z line shouldn’t undergo routine endoscopic biopsies
b) W/o visible lesions, patient w/ a Z line < 1cm of proximal displacement from the top of the gastric folds should not undergo routine endoscopic biopsies
conditional, low evidence
Suggest at least 8 biopsies in screening w/ Seattle protocol for segments longer than 4 cm
conditional, low evidence
Recommend dysplasia of any grade on biopsies of BE be confirmed by a second pathologist w/ GI expertise
strong, low evidence
Suggest single screening EGD w/ chronic GERD and 3 or more additional risk factors for BE: male sex, > 50 yo, white race, tobacco smoking, obesity, family hx of BE in first-degree relative
conditional, very low evidence
Suggest swallowable capsule device combined w/ biomarker is an acceptable alternative to EGD for BE screening
conditional, very low evidence
Suggest against repeat screening in patients w/ an initial negative screen
conditional, low evidence
Recommend both white light endoscopy and chromoendoscopy in patients undergoing BE surveillance
strong, moderate evidence
Recommend structured biopsy protocol to minimize detection bias
strong, low evidence
Suggest endoscopic surveillance be performed in patients w/ BE at intervals dictated by the degree of dysplasia on previous biopsies
conditional, very low evidence
Recommend that length of BE segment be considered when assigning surveillance intervals w/ longer intervals for those w/ BE segments < 3cm
strong, moderate evidence
Could not make a recommendation on the use of TissueCypher
Suggest at least once a day PPI in patients w/ BE w/o a contraindication
conditional, very low evidence
Could not recommend on combination therapy w/ ASA and PPI in patients w/ BE
Suggest against the use of anti reflux surgery as an antineoplastic measure in BE patients
conditional, low evidence
Recommend endoscopic eradication in patients w/ BE w/ HGD or IMC
strong, moderate evidence
Suggest eradication in patient w/ BE w/ LGD to reduce the risk of progression to HGD or EAC vs close surveillance
conditional, moderate evidence
Suggest initial endoscopic resection of any visible lesions before the application of ablative therapy in patients w/ BE undergoing eradication therapy
conditional, very low evidence
Suggest patients w/ BE undergoing eradication therapy be treated in high-volume centers
conditional, very low evidence
Recommend an endoscopic surveillance program in patients w/ BE who have completed successful eradication
strong, moderate evidence
