- A new clinical practice guideline from the American Gastroenterological Association (AGA) addresses seven key clinical domains, including the role of endoscopic surveillance, management of columnar-lined esophagus under 1 cm, optimal imaging techniques, adjunctive sampling methods, biomarkers for risk stratification, chemoprevention, and the role of anti-reflux procedures in preventing disease progression.
- A panel reached a consensus on eight recommendations, including a conditional recommendation supporting endoscopic surveillance for patients with nondysplastic Barrett’s esophagus, and the use of daily proton pump inhibitor therapy over no therapy or anti-reflux surgery to prevent disease progression.
- Surveillance is not recommended for patients with columnar-lined esophagus under 1 cm, while a strong recommendation was made for using high-definition white light endoscopy in combination with chromoendoscopy rather than white light endoscopy alone.
- No recommendation was made regarding the use of enhanced sampling techniques such as wide area transepithelial sampling.
- The guideline authors emphasized the importance of high-quality endoscopy, structured biopsy protocols, and confirmation of dysplasia.
- Shared decision-making between clinicians and patients is necessary to ensure management aligns with patient preferences and values.
AGA releases updated guideline on endoscopic surveillance of Barrett’s esophagus
Conexiant
October 22, 2025
