Barrett's esophagus detection: Multiple biopsies are useful, even better if you have an “X” on your map

Barrett's esophagus (BE), defined as the replacement of physiological squamous epithelium of the lower esophagus by metaplastic columnar epithelium containing goblet cells, is a premalignant condition that can lead to esophageal adenocarcinoma through dysplasia with an annual risk of about 0.5% [1–3]. The major determinant of BE is represented by gastro-esophageal reflux, which promotes chronic inflammation and progressively induces the metaplastic transformation in predisposed subjects [4,5]. Indeed, several pathophysiological studies carried out with the state-of-the-art technology clearly demonstrated that the severity of BE directly correlates with esophageal acid exposure and reflux occurrence of any type [6,7].

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