Challenges in Endoscopic Eradication Therapy : Refractory and Recurrent Barrett’s Esophagus - 17/11/25

Doi : 10.1016/j.giec.2025.05.011

Kevin P. Shah, MD ^a,^{^{1
Present address: 1000 S Michigan Avenue, Apt 1510, Chicago, IL 60605.}}, Vismaya Bachu, MD ^b,^{^{2
Present address: 1515 Granville Avenue, Apt 323, Los Angeles, CA 90025.}}, Shirin Dey, MD, MS ^c,^{^{3
Present address: 5540 N Glenwood Avenue Apt 3S, Chicago, IL 60640.}}, Domenico A. Farina, MD ^a,^{^{4
Present address: 635 S Stough Street, Hinsdale, IL 60521.}}, Raman Muthusamy, MD, MAS ^d,^{^{5
Present address: 14721 Round Valley Drive, Sherman Oaks, CA 91403.}}, Srinadh Komanduri, MD, MS ^a,^{^{6
Present address: 404 Ridge Avenue, Clarendon Hills, IL 60514.},}^⁎
^a Department of Gastroenterology and Hepatology, Northwestern Memorial Hospital, Chicago, IL, USA
^b Department of Internal Medicine, University of California, Los Angeles, CA, USA
^c Department of Internal Medicine, Northwestern Memorial Hospital, Chicago, IL, USA
^d Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

^∗Corresponding author. NMH/Arkes Family Pavilion, 14th Floor, 676 N Saint Clair, Chicago, IL 60611.NMH/Arkes Family Pavilion14th Floor676 N Saint ClairChicagoIL60611

Résumé

Advances in endoscopic eradication therapy (EET) have improved the ability to achieve complete eradication of intestinal metaplasia. A multimodal approach of endoscopic resection followed by ablative therapy remains the cornerstone of EET for BE and BE-related dysplasia. However, challenges exist in patients with refractory and recurrent BE. Modifiable risk factors such as uncontrolled reflux should be addressed medically or surgically. Salvage therapy can be utilized in refractory BE, but endoscopists should be cautious of adverse effects such as stricture formation. Principles of management of recurrent BE are similar to patients undergoing initial EET.

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Keywords : Barrett’s esophagus, Dysplasia, Endoscopic eradication therapy, Refractory disease, Recurrent disease

Plan

Key points

Introduction

Refractory Barrett’s esophagus

Risk Factors and Predictors of Refractory Barrett’s Esophagus

Addressing Reflux in Refractory Barrett’s Esophagus

Salvage Endoscopic Eradication Therapy for Refractory Barrett’s Esophagus

Recurrent Barrett’s esophagus

Surveillance Strategies for Barrett’s Esophagus after Endoscopic Eradication Therapy

Risk Factors and Predictors of Recurrent Barrett’s Esophagus

Risk of Barrett’s Esophagus Recurrence

High-quality Examination for Barrett’s Esophagus

Management of Recurrent Barrett’s Esophagus

Summary

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Vol 36 - N° 1

P. 225-238 - janvier 2026 Retour au numéro

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Challenges in Endoscopic Eradication Therapy : Refractory and Recurrent Barrett’s Esophagus - 17/11/25

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