Diagnosis and Management of Barrett’s Esophagus with Dr. Nicholas Shaheen
In this episode of Curbside Consults, we examine the latest guidelines on the diagnosis and management of Barrett’s esophagus by the American College of Gastroenterology (ACG). We are joined by Dr. Nick Shaheen, a Professor of Medicine and Chief of Gastroenterology and Hepatology at UNC Chapel Hill, and one of the guideline authors.
00:05 – Intro 00:35 – Guideline process 01:50 – Basics of Barrett’s esophagus 04:27 – Which patients should we screen? 07:40 – Consideration of patients without reflux 08:53 – Strength of evidence of screening 10:50 – Discrepancies in endoscopy utilization 12:20 – Recommended modalities for screening 16:30 – Repeat endoscopy is unnecessary 18:20 – Exception: severe esophagitis on initial screen 19:35 – Treatment of Barrett’s esophagus 21:37 – Acid suppression for Barrett’s esophagus 23:37 – No evidence for antireflux surgery 25:00 – Concluding remarks
The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.
Nick Shaheen, MD, is Professor of Medicine and Chief of Gastroenterology and Hepatology at UNC Chapel Hill.
Clement Lee, MD, MSc, is a 2021–2022 NEJM Editorial Fellow. He is currently an internal medicine hospitalist at Beth Israel Deaconess Medical Center and a pediatric hospitalist at Lowell General Hospital. He completed his internal medicine-pediatrics residency at Penn-CHOP.