Barrett esophagus: endoscopic findings and what to biopsy.

Abstract:

:Barrett esophagus (BE) is considered the precursor for nearly all cases of esophageal adenocarcinoma. The potential sequence from intestinal metaplasia to dysplasia to cancer can best be monitored by careful endoscopic observation and surveillance biopsies. The ability to diagnose BE, biopsy accurately, and appropriately monitor are requisites for all who care for patients with this disorder. The normal endoscopic anatomy of the esophagogastric junction region and the changes that are associated with BE are discussed. The relationship of the squamocolumnar mucosal junction to the proximal margin of the gastric folds and the distal extent of the linear esophageal vessels is the principal landmark for diagnosis. Chromoendoscopy with methylene blue and Lugol iodine will enhance endoscopic observation, thereby allowing directed biopsies. Biopsy forceps and technique are reviewed along with the when and where for surveillance biopsies. Since most dysplasia and intramucosal cancer is focal and invisible to the endoscopist, it is easy to understand why the sampling error exceeds 95% using a standard four-quadrant biopsy protocol. Currently, this sampling error can be reduced by four-quadrant biopsies at closer intervals and biopsies of even the most minor focal abnormalities of mucosa in the BE segment. Screening may be enhanced in the future depending upon successful development of new cytologic, spectrographic, and tomographic methods capable of identifying foci of dysplasia or cancer that can be confirmed by targeted biopsies.

journal_name

J Clin Gastroenterol

authors

Boyce HW

doi

10.1097/00004836-200305001-00003

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

S6-18; discussion S26-8

issue

5 Suppl

eissn

0192-0790

issn

1539-2031

journal_volume

36

pub_type

杂志文章,评审
  • Splenosis presenting as an ulcerated gastric mass: endoscopic and endoscopic ultrasonographic imaging.

    abstract::A case of an ulcerated gastric wall mass ultimately found to be splenosis is presented in which the index patient had endoscopic and endoscopic ultrasonographic evaluation prior to resection. Although no visual features identified this mass as a splenic implant preoperatively, the lesion appeared to be atypical for le...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199904000-00020

    authors: Deutsch JC,Sandhu IS,Lawrence SP

    更新日期:1999-04-01 00:00:00

  • Crohn's disease associated with autoimmune neutropenia.

    abstract::We report a 29-year-old woman with a 20-year history of Crohn's disease and neutropenia. Because of repeated complications of Crohn's disease, she has undergone three intestinal resections and also has had recurrent skin abscesses, sinusitis, and pneumonia. Persistent neutropenia has been noted throughout the course o...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199106000-00016

    authors: Stevens C,Peppercorn MA,Grand RJ

    更新日期:1991-06-01 00:00:00

  • Candida overgrowth after treatment of duodenal ulcer. A comparison of cimetidine, famotidine, and omeprazole.

    abstract::Acid-reducing drugs can cause increased growth of microbes, including fungus, because of high gastric pH. Our purpose was to evaluate the occurrence of mycotic infection in patients with duodenal ulcer on anti-ulcer therapy and to compare the effects of cimetidine, famotidine, and omeprazole. Eighty patients with duod...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00004836-199607000-00003

    authors: Goenka MK,Kochhar R,Chakrabarti A,Kumar A,Gupta O,Talwar P,Mehta SK

    更新日期:1996-07-01 00:00:00

  • Co-occurrence of hepatocellular carcinoma and lymphoma in patients with hepatitis C virus cirrhosis.

    abstract::The association of hepatitis C virus (HCV) with neoplasia is not completely understood. Hepatitis C virus is hepatolymphotrophic. It is considered an inducing factor of hepatocellular carcinoma (HCC) and is associated with various types of lymphomas. We describe a patient with HCV cirrhosis who developed gastric lymph...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200104000-00023

    authors: Shapira MY,Muszkat M,Braunstein I,Gotsman I

    更新日期:2001-04-01 00:00:00

  • Normal thiopurine methyltransferase levels do not eliminate 6-mercaptopurine or azathioprine toxicity in children with inflammatory bowel disease.

    abstract::6-mercaptopurine (6-MP) and azathioprine (AZA) are used to treat inflammatory bowel disease (IBD). Side effects include infection, leukopenia, hepatitis, and pancreatitis. The level of thiopurine methyltransferase (TPMT), which metabolizes 6-MP to 6-methylmercaptopurine, may reflect the risk of side effects. We sought...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200006000-00011

    authors: Kader HA,Wenner WJ Jr,Telega GW,Maller ES,Baldassano RN

    更新日期:2000-06-01 00:00:00

  • Chronic Pneumocystis carinii infection of the liver. A case report and review of the literature.

    abstract::Pneumocystis carinii infection of the liver is being reported with increasing frequency in patients with acquired immune deficiency syndrome (AIDS). The clinical picture typically resembles hepatitis. We report such an occurrence in a patient with persistent elevation of alkaline phosphatase and gamma-glutamyl transpe...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199207000-00013

    authors: Merkel IS,Good CB,Nalesnik M,Roseman SR

    更新日期:1992-07-01 00:00:00

  • Is a Fundamental Design Change for Gastrointestinal Endoscopes Required?

    abstract::Since the first fiberoptic instruments, gastrointestinal endoscopy has shaped the field of gastroenterology and is now a key diagnostic and therapeutic tool. Compared with the initial fiberoptic endoscopes state-of-the-art optical chips (or charge-coupled device technology) allowed a quantum leap in image quality. Des...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001430

    authors: Holtmann GJ,Huelsen A,Shah A,Hourigan LF,Morrison M

    更新日期:2021-01-01 00:00:00

  • Predictive factors for metachronous recurrence of early gastric cancer after endoscopic treatment.

    abstract::Since endoscopic treatment has been evaluated and become established as treatment for early gastric cancer, metachronous recurrence has become a major problem. In this report, predictive factors for recurrence were studied using the Kaplan-Meier method and Cox's proportional hazards regression model in 76 patients who...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199907000-00011

    authors: Arima N,Adachi K,Katsube T,Amano K,Ishihara S,Watanabe M,Kinoshita Y

    更新日期:1999-07-01 00:00:00

  • Psychotropic agents in irritable bowel syndrome.

    abstract::The use of antidepressants to treat patients with irritable bowel syndrome (IBS) has been extended in recent years because of their possible neuromodulatory and analgesic effects, generally in doses that do not have antidepressant effects. There seems to be sufficient evidence to support the recommendation that psycho...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-200207001-00010

    authors: Wald A

    更新日期:2002-07-01 00:00:00

  • Patients With Inflammatory Bowel Diseases Are at Higher Risk for Meningitis.

    abstract:BACKGROUND:The epidemiology of meningitis is unknown in inflammatory bowel disease (IBD) patients. GOALS:We aimed to determine the incidence of and risk factors for meningitis in IBD patients. STUDY:We conducted a retrospective cohort and nested case-control study in the Quintiles IMS Legacy PharMetrics Adjudicated C...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000001365

    authors: Kochar B,Jiang Y,Long MD

    更新日期:2020-05-29 00:00:00

  • Brain-gut response to stress and cholinergic stimulation in irritable bowel syndrome. A preliminary study.

    abstract::To investigate the influence of the brain-gut interactions on the pathophysiology of irritable bowel syndrome (IBS), we compared such patients (n = 10) with healthy control subjects (n = 11) by measuring the pressure of the colon and small intestine simultaneously with analysis of power spectrum of the electroencephal...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199309000-00009

    authors: Fukudo S,Nomura T,Muranaka M,Taguchi F

    更新日期:1993-09-01 00:00:00

  • Treatment options for uncomplicated diverticular disease of the colon.

    abstract::Patients affected by uncomplicated diverticular disease (DD) suffer from colicky, unexplained, recurrent, and short-lived but often debilitating abdominal pain and alteration in bowel habit. Although the goals of therapy, such as to improve symptoms and to prevent both recurrent attacks and complications, are clearly ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MCG.0b013e3181b3ab2e

    authors: Rocco A,Compare D,Caruso F,Nardone G

    更新日期:2009-10-01 00:00:00

  • Are antibiotics useful in the management of nontoxic severe ulcerative colitis?

    abstract::Severely ill patients with ulcerative colitis are usually treated with parenteral corticoids. Those with signs of systemic toxicity usually receive antibiotics as well. However, the role of antibiotics in patients without high fever, profound leukocytosis, peritoneal signs or megacolon is not clear. Since 1985, seven ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199307000-00005

    authors: Peppercorn MA

    更新日期:1993-07-01 00:00:00

  • Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiac disease.

    abstract:GOALS:Our objective was to determine whether high serologic IgA tissue transglutaminase antibodies (TTGA) are exclusively associated with celiac disease (CD). BACKGROUND:IgA TTGA are found in the serum of most individuals with CD. This serologic marker is used to screen individuals with suspected CD for duodenal biops...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MCG.0b013e31802e70b1

    authors: Donaldson MR,Book LS,Leiferman KM,Zone JJ,Neuhausen SL

    更新日期:2008-03-01 00:00:00

  • Esophageal pressure topography, body position, and hiatal hernia.

    abstract:INTRODUCTION:Whether body position affects lower esophageal sphincter (LES) function and detection of hiatal hernia is unknown. Moreover, the yield of high-resolution esophageal pressure topography (HREPT) when compared with endoscopy for detection of hiatal hernia is unclear. AIM:The aims of this study were to examin...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0000000000000057

    authors: Hashmi S,Rao SS,Summers RW,Schulze K

    更新日期:2014-03-01 00:00:00

  • Urinary antibody titers to Helicobacter pylori and an impact of clinical characteristics.

    abstract::This study evaluates the clinical usefulness of titers of antibody to Helicobacter pylori (Hp) in a urine-based enzyme-linked immunosorbent assay (URINELISA; Otsuka Pharmaceutical, Tokushima, Japan) by comparing values of serum antibody to Hp in an already commercialized kit in a population of 250 asymptomatic individ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200304000-00010

    authors: Yamamoto T,Tamura M,Ishii T,Anjiki H,Hattori K,Saitoh M,Sanaka M,Kuyama Y

    更新日期:2003-04-01 00:00:00

  • Injection sclerotherapy as a cause of Klebsiella pneumoniae peritonitis.

    abstract::We report a case of Klebsiella pneumoniae peritonitis after endoscopic sclerotherapy and discuss its pathogenesis and risk factors. We also review previous cases in the literature and make recommendations for prophylactic therapy. Endoscopists should be aware of peritonitis as a possible complication of endoscopic scl...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199212000-00013

    authors: Trotter JF,Peterson WL

    更新日期:1992-12-01 00:00:00

  • Mesenteric node enlargement as a cause of intestinal variceal hemorrhage in nodular lymphoid hyperplasia.

    abstract::Jejunal varices were a cause of recurrent gastrointestinal hemorrhage in an 18-year-old man with common variable immunodeficiency and nodular lymphoid hyperplasia of the small intestine. Despite numerous procedures, including upper gastrointestinal endoscopy, colonoscopy, arteriography, and exploratory laparotomy no a...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198510000-00010

    authors: Freiman JS,Gallagher ND

    更新日期:1985-10-01 00:00:00

  • Silybin treatment is associated with reduction in serum ferritin in patients with chronic hepatitis C.

    abstract:GOALS:The goal of this study was to examine the effect of a standardized silybin and soy phosphatidylcholine complex (IdB 1016) on serum markers of iron status. BACKGROUND:Milk thistle and its components are widely used as an alternative therapy for liver disease because of purported antioxidant, anti-inflammatory, an...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/MCG.0b013e31815cff36

    authors: Bares JM,Berger J,Nelson JE,Messner DJ,Schildt S,Standish LJ,Kowdley KV

    更新日期:2008-09-01 00:00:00

  • Acceptance of telemanagement is high in patients with inflammatory bowel disease.

    abstract:GOALS:Assess acceptance and attitudes regarding telemanagement (HAT) in patients with inflammatory bowel disease (IBD). BACKGROUND:Noncompliance is a barrier to successful outcomes in patients with IBD. Novel methods for monitoring and assessing compliance are needed. STUDY:HAT consists of a laptop connected to a wei...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200603000-00006

    authors: Cross RK,Arora M,Finkelstein J

    更新日期:2006-03-01 00:00:00

  • Humoral intestinal immunity in systemic lupus erythematosus.

    abstract::Forty-five patients with systemic lupus erythematosus (SLE) underwent a cross-sectional study to evaluate intestinal secretory immunity. Peroral jejunal biopsy with histologic and immunohistochemical assessment of the mucosa were carried out in the patients and in 12 healthy volunteers. It was observed that an altered...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-200001000-00009

    authors: Elia C,Souza H,Carvalho AT,Madi K,Mello CA,Oliveira A,Cuckier R,Papi JA

    更新日期:2000-01-01 00:00:00

  • Gunshot cholecystitis.

    abstract::A 15-year-old boy developed traumatic cholecystitis from a BB shot that lodged in his gallbladder. This is an unusual cause of gallbladder disease, and we review the literature. ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/00004836-199512000-00016

    authors: Petersen JM,Knight TT

    更新日期:1995-12-01 00:00:00

  • Efficacy of low-dose antacids in the treatment of peptic ulcers: pharmacological explanation?

    abstract::Antacids have been used as remedies for benign gastroduodenal disorders for centuries. They were regarded to be effective in relieving gastric pain and symptoms of hyperacidity and in promoting ulcer healing. The effectiveness was based on empiric observations and was not derived from the controlled clinical trials da...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,meta分析

    doi:10.1097/00004836-199112001-00022

    authors: Sewing KF

    更新日期:1991-01-01 00:00:00

  • Extrahepatic portal venous thrombosis: frequent recognition of associated diseases.

    abstract::Twelve patients with obstruction of the extrahepatic portal venous system were seen at the Tufts-New England Medical Center between 1970 and 1979; a cause for the portal vein thrombosis was detected in 11. These included pancreatic disease (4); hematologic disorders (2); postoperative complications of laparotomy (3); ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198504000-00009

    authors: Brown KM,Kaplan MM,Donowitz M

    更新日期:1985-04-01 00:00:00

  • The efficacy of intravenous contrast-enhanced 16-raw multidetector CT colonography for detecting patients with colorectal polyps in an asymptomatic population in Korea.

    abstract:PURPOSE:The purpose of this study is to compare the sensitivity of computed tomography (CT) colonography (CTC) with that of colonoscopy for detecting patients with colorectal polyps in an asymptomatic screening population in Korea, thus to evaluate a possibility, whether CTC could be used as a screening tool for colore...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31811edcb7

    authors: Kim YS,Kim N,Kim SH,Park MJ,Lim SH,Yim JY,Cho KR,Kim SS,Kim DH,Eun HW,Cho KS,Kim JH,Choi BI,Jung HC,Song IS,Shin CS,Cho SH,Oh BH

    更新日期:2008-08-01 00:00:00

  • Perforation of small intestine caused by Churg-Strauss syndrome.

    abstract::In Churug-Strauss Syndrome (CSS), gastrointestinal tract (GIT) is an uncommon site of involvement. In addition to review of recent literature, we herein report a case of CSS with unusual involvement of GIT. The patient was being treated for idiopathic hypereosinophilic syndrome for 2 years; he later developed acute pe...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199610000-00017

    authors: Sharma MC,Safaya R,Sidhu BS

    更新日期:1996-10-01 00:00:00

  • The Cronkhite-Canada syndrome with focus on immunity and infection. Report of a case.

    abstract::A 64-year-old man developed diffuse gastrointestinal polyposis, protein-losing enteropathy, skin pigmentation, hair loss, and unique nail changes. He also exhibited pulmonary tuberculosis and impaired immunity with skin anergy, poor lymphocyte mitogens stimulation test, and low serum immunoglobulin. We discuss the rel...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198710000-00018

    authors: Lin HJ,Tsai YT,Lee SD,Lai KH,Ng WW,Tam TN,Lin HC,Liou LB,Tsay SH

    更新日期:1987-10-01 00:00:00

  • Esophageal tuberculosis presenting as intramural esophagogastric hematoma in a hemophiliac patient.

    abstract::A spontaneous intramural esophagogastric hematoma developed in a patient with hemophilia A. The hematoma did not resolve after antihemophiliac factor replacement but ruptured into the stomach causing massive gastrointestinal bleeding. The associated enlarged right tracheobronchial gland and the histopathological findi...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-199203000-00017

    authors: Intragumtornchai T,Israsena S,Benjacholamard V,Lerdlum S,Benjavongkulchai S

    更新日期:1992-03-01 00:00:00

  • Penetrating duodenal ulcer from hepatic artery chemotherapy infusion catheter. Successful conservative medical management.

    abstract::A 45-year-old woman receiving continuous infusions of 5-fluoro-2'-deoxy-uridine into the hepatic artery through a surgically implanted intraarterial catheter for hepatic metastases from adenocarcinoma of the colon, developed acute epigastric pain and anemia. Endoscopy demonstrated a duodenal ulcer with a portion of th...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00004836-198808000-00016

    authors: Hutchins LF,Webb RT,Ortego TJ,Lang NP,Navab F

    更新日期:1988-08-01 00:00:00

  • Thiazolidinediones for the treatment in NASH: sustained benefit after drug discontinuation?

    abstract:BACKGROUND:Although of unproven benefit for nonalcoholic steatohepatitis (NASH), thiazolidinediones (TZDs) have emerged as a promising therapy. Little evidence exists, however, regarding sustained effects of TZDs in NASH after drug discontinuation. A recent clinical study suggests that relapse of NASH pathophysiology i...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章

    doi:10.1097/MCG.0b013e31818f4fc2

    authors: Argo CK,Iezzoni JC,Al-Osaimi AM,Caldwell SH

    更新日期:2009-07-01 00:00:00