Leading article
Barrett's oesophagus and proton pump inhibitors: a pathological perspective
| The first 150 words of the full text of this article appear below. |
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Introduction |
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In Western communities, the incidence of oesophageal
adenocarcinoma continues to increase in an almost epidemic manner,
greater than any other common epithelial malignancy.1 2
There is therefore increasing interest in the treatment strategies that reduce reflux, especially of acid, into the oesophagus in an attempt to
reduce the neoplastic potential of Barrett's oesophagus/columnar lined
oesophagus (CLO), the most important predisposing factor for
oesophageal adenocarcinoma. The effect of surgical antireflux procedures on CLO is still controversial with no clear evidence of
regression of CLO after these procedures. There is also no evidence
that acid lowering drugs such as the H2 blockers can reverse the glandular metaplasia of CLO. The efficacy of the powerful acid reducing agents, the proton pump inhibitors (PPIs), in causing regression of CLO is also controversial. Although many believe that
these drugs have no great effect on CLO and most accept that these
drugs do not result
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