Assessing the regression of Barrett esophagus: Don't try it at home

The discovery of a therapy to induce regression of intestinal metaplasia is one of the main objectives of clinical research in Barrett esophagus. As acid-control drugs have proved ineffective for this purpose, current interest is focused on antireflux surgery, particularly fundoplication. Several studies, including the one discussed in this commentary, have reported regression metaplasia and the absence of progression to high-grade dysplasia or adenocarcinoma after successful fundoplication, suggesting that this procedure is an effective approach for the management of patients with Barrett esophagus. The crucial question whether regression and absence of progression will result in the prevention of Barrett-associated adenocarcinoma may be answered by long-term follow-up of operated patients.