Role of acid suppression in the development and progression of dysplasia in patients with Barrett's esophagus.

Abstract

Barrett's esophagus (BE) usually develops in patients with gastroesophageal reflux disease and therefore it has been suggested that esophageal acid exposure plays an import role in the initiation of BE and its progression towards esophageal adenocarcinoma (EAC). The mechanisms whereby acid exposure causes BE are not completely revealed and the potential role of esophageal acid exposure in carcinogenesis is unclear as well. Since acid exposure is thought to play an important role in the progression of BE, therapies aimed at preventing the development of EAC have primarily focused on pharmacological and surgical acid suppression. In clinical practice, acid suppression is effective in relieving reflux symptoms and decreases esophageal acid exposure in most patients. However, in some individuals, pathological acid exposure persists and these patients continue to be at risk for developing dysplasia or EAC. To date, published trials suggest that acid suppression is able to prevent the development and progression of dysplasia in patients with BE, but definite and compelling proof is still lacking. This article reviews the mechanisms of acid-induced carcinogenesis in BE and the role of acid suppression in the prevention of neoplastic progression.

• Authors: F Kastelein, M C W Spaander, K Biermann, B Vucelic, E J Kuipers, M J Bruno
• Journal: Digestive diseases (Basel, Switzerland) (Dig Dis) Vol. 29 Issue 5 Pg. 499-506 ( 2011) ISSN: 1421-9875 [Electronic] Switzerland
• PMID: 22095018 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Chemical References

• Proton Pump Inhibitors

Topics

• Barrett Esophagus (drug therapy, pathology, physiopathology)
• Cell Transformation, Neoplastic (pathology)
• Disease Progression
• Gastric Acid (metabolism)
• Humans
• Proton Pump Inhibitors (therapeutic use)