Abstract
Summary
BACKGROUND: The history of Barrett's oesophagus has taken nearly six decades to evolve, and is still in the process of understanding. METHODS: Review of the history of Barrett's oesophagus. RESULTS: The vigour with which both surgeons and gastroenterologists have pursued this condition is unparalleled. At the outset the presentations of stricture, ulceration and bleeding were of interest mainly to surgeons. The columnar-lining was first thought to be congenital in origin, and only later was the association with gastroesophageal reflux accepted. Histological appraisal made great strides towards the understanding of the disease and in recent years has again played a major role in this regard. Tests of oesophageal function in the columnar-lined oesophagus showed severe deterioration, and led to measures to treat and protect the oesophagus from acid reflux. The realization that this was a pre-malignant lesion added enormously to the interest and efforts to prevent malignant deterioration. Molecular biological studies have opened new vistas to the pathogenesis of the changes taking place in the epithelium, and have introduced advances in treatment. CONCLUSIONS: Earlier diagnosis has prompted less radical surgical treatment methods and better overall results. The condition has now become more prevalent in far Eastern countries, expanding the interest to causative dietary factors. This full cycle of research now focuses on prevention of the disease and its complications.