Barrett's esophagus secondary prevention: Difference between revisions
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{{Barrett's esophagus}} | {{Barrett's esophagus}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}; {{AMK}} | ||
==Overview== | ==Overview== | ||
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Recommendations: | Recommendations: | ||
* Therapy with medications effective to treat GERD symptoms and to heal reflux esophagitis is strongly recommended. | * [[Therapy]] [[with]] [[medications]] [[effective]] [[to]] [[treat]] [[GERD]] [[symptoms]] [[and]] [[to]] [[heal]] [[reflux esophagitis]] [[is]] [[strongly]] [[recommended]]. | ||
* Do not attempt to eliminate acid exposure of the esophagus | * [[Do]] [[not]] [[attempt]] [[to]] [[eliminate]] [[acid]] [[exposure]] [[of]] [[the]] [[esophagus]] | ||
# Use proton pump inhibitors in doses greater than once daily. There is no evidence that higher doses produce a risk reduction in cancer. | # [[Use]] [[proton pump inhibitors]] [[in]] [[doses]] [[greater]] [[than]] [[once]] [[daily]]. [[There]] [[is]] [[no]] [[evidence]] [[that]] [[higher]] [[doses]] [[produce]] [[a]] [[risk]] [[reduction]] [[in]] [[cancer]]. | ||
# Titrate proton pump inhibitors dose by esophageal pH monitoring. | # [[Titrate]] [[proton pump inhibitors]] [[dose]] [[by]] [[esophageal]] [[pH]] [[monitoring]]. | ||
# | # [[Anti-reflux]] [[surgery]]. [[This]] [[is]] [[not]] [[more]] [[effective]] [[than]] [[medical]] [[therpay]]. | ||
Risks and benefits of long-term PPI therapy should be discussed with the patients. | [[Risks]] [[and]] [[benefits]] [[of]] [[long-term]] [[PPI]] [[therapy]] [[should]] [[be]] [[discussed]] [[with]] [[the]] [[patients]]. | ||
* Do not use aspirin to prevent esophageal adenocarcinoma in the absence of other indications (e.g. cardiovascular risk factors). Although evidence suggests NSAIDs may decrease the incidence of esophageal cancer, it is not clear if benefits outweight the risks of using this medications.<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |pmid=21376940 |doi=10.1053/j.gastro.2011.01.030 |url=}}</ref> | * [[Do]] [[not]] [[use]] [[aspirin]] [[to]] [[prevent]] [[esophageal]] [[adenocarcinoma]] [[in]] [[the]] [[absence]] [[of]] [[other]] [[indications]] (e.g. [[cardiovascular]] [[risk factors]]). [[Although]] [[evidence]] [[suggests]] [[NSAIDs]] [[may]] [[decrease]] [[the]] [[incidence]] [[of]] [[esophageal]] [[cancer]], [[it]] [[is]] [[not]] [[clear]] [[if]] [[benefits]] [[outweight]] [[the]] [[risks]] [[of]] [[using]] [[this]] [[medications]].<ref name="pmid21376940">{{cite journal |author=Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ |title=American Gastroenterological Association medical position statement on the management of Barrett's esophagus |journal=Gastroenterology |volume=140 |issue=3 |pages=1084–91 |year=2011 |pmid=21376940 |doi=10.1053/j.gastro.2011.01.030 |url=}}</ref> | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
Revision as of 18:55, 7 November 2017
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Barrett's Esophagus Microchapters |
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Barrett's esophagus secondary prevention On the Web |
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American Roentgen Ray Society Images of Barrett's esophagus secondary prevention |
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Risk calculators and risk factors for Barrett's esophagus secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Amresh Kumar MD [2]
Overview
There are no established measures for the secondary prevention of [disease name].
OR
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
Secondary prevention
Recommendations:
- Therapy with medications effective to treat GERD symptoms and to heal reflux esophagitis is strongly recommended.
- Use proton pump inhibitors in doses greater than once daily. There is no evidence that higher doses produce a risk reduction in cancer.
- Titrate proton pump inhibitors dose by esophageal pH monitoring.
- Anti-reflux surgery. This is not more effective than medical therpay.
Risks and benefits of long-term PPI therapy should be discussed with the patients.
- Do not use aspirin to prevent esophageal adenocarcinoma in the absence of other indications (e.g. cardiovascular risk factors). Although evidence suggests NSAIDs may decrease the incidence of esophageal cancer, it is not clear if benefits outweight the risks of using this medications.[1]
Secondary Prevention
- There are no established measures for the secondary prevention of [disease name].
OR
- Effective measures for the secondary prevention of [disease name] include:
- [Strategy 1]
- [Strategy 2]
- [Strategy 3]
References
- ↑ Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (2011). "American Gastroenterological Association medical position statement on the management of Barrett's esophagus". Gastroenterology. 140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030. PMID 21376940.