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Diagnosis of Barrett esophagus (BE) depends on accurately directed endoscopic esophageal biopsy of columnar-appearing mucosa and subsequent confirmation of specialized columnar metaplasia. However, at the time of endoscopy, if a patient has macroscopic evidence of erosive esophagitis (EE), targeting the biopsy properly or establishing a clear diagnosis can be difficult.
To determine the value of postponing endoscopy until an attempt had been made to heal EE, investigators in Kansas treated 172 referred patients who had reflux symptoms and endoscopic evidence of EE without obvious BE. Patients received proton-pump inhibitors (PPIs) for 8 to 16 weeks (mean duration of PPI therapy, 11 weeks) and then underwent repeat endoscopy. After therapy, E…