Results of a PubMed search for publications with

the term “Barrett’s esophagus”, published up to the end of 2009, shown in Fig. 1, chart the explosion of information on this thorny clinical problem. The most recent general reviews on BE are from Shaheen and Richter,2 Sharma3 and Spechler et al..4 The emphasis of this article is on recent information that is driving change in the clinical management of BE. For reasons that will be explained, this article defines BE as the presence of esophageal columnar metaplasia of any histologic type or extent. In 1903, Norman Barrett was born at home in Adelaide, just 3 km from this Everolimus concentration author’s office.4,7,8 He moved permanently to England with his family when he was about 10. Barrett, a prolific author,7 is of course best known for his single-author 1950 paper,9“Chronic Torin 1 concentration peptic ulcer of the oesophagus and ‘oesophagitis’ ”. Despite a diligent review of the published literature, Barrett, who was relying primarily on gross pathology, favored an incorrect etiologic interpretation, though he did also discuss what is now believed

to be the correct pathogenesis of what others christened as “Barrett’s Oesophagus” in 1953.10 In 1957 Barrett belatedly accepted the current basic pathogenetic model and in the same paper made clinicians aware of the association between esophageal adenocarcinoma (EA) and esophageal columnar metaplasia, appropriately crediting others for first suggesting this association.11 Barrett’s interpretative stumbles have lead some to the view that his achievement was insufficient to merit “naming rights” for this then obscure, but already noted condition. This is a harsh judgment in the light of the investigative methods available to Barrett Celecoxib in

the late 1940s.9 Regardless of whether it is deserved that Barrett’s name is attached to this clinical entity, it is now so entrenched that we have it forever: also, whether we use the eponym “Barrett’s esophagus” fades into insignificance compared with the need to have the same meaning applied to this term throughout the world, so that the disabling ambiguities that have arisen from use of differing histopathologic and endoscopic definitions become a thing of the past.12,13 In the 1950s, the cases of EA that Barrett observed in association with BE were advanced, presenting mainly with esophageal obstruction.11 The almost universal presence of metastases at this stage caused a dismal prognosis, even if effective palliation was achieved by esophagectomy.