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British Society of Gastroenterology guidelines for the diagnosis of Barrett’s oesophagus: are we casting the net too wide?
  1. S J Murphy1,
  2. B T Johnston2,
  3. L J Murray3
  1. 1Division of Gastroenterology, Mount Sinai Medical Center, New York, New York, USA
  2. 2Royal Group of Hospitals, Belfast, UK
  3. 3Cancer Epidemiology and Prevention Research, Centre for Clinical and Population Sciences, Queen’s University Belfast, Royal Group of Hospitals, Belfast, UK
  1. Correspondence to:
    S J Murphy
    Division of Gastroenterology, Box 1069, Mount Sinai Medical Center, One Gustave Levy Place, New York, NY 10029-6574, USA; seamus.murphy{at}mssm.edu

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We read with interest the British Society of Gastroenterology guidelines for the diagnosis and management of Barrett’s columnar-lined oesophagus1 and the related commentary by Professor Playford (Gut 2006;55:442–3). One of the new recommendations in these guidelines relates to the diagnosis of Barrett’s oesophagus. The guidelines state that “the presence of areas of intestinal metaplasia, although often present, is not a requirement for diagnosis”. This is out of step with guidelines from the US, where intestinal metaplasia is required to establish a diagnosis of Barrett’s oesophagus.2 The rationale for the British guidelines is that sampling errors at initial endoscopy may miss areas affected with …

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