Treatment of Barrett's Esophagus to Prevent Neoplastic Progression

Barrett's esophagus carries a meaningful risk of progression toward dysplasia and malignancy. Selecting an appropriate first-line strategy — and acting on it consistently — is the clinical priority.

First-Line Approach

The evidence-based protocol centres on a specific class of daily oral acid-suppressing therapy, recommended over no pharmacological treatment and over surgical alternatives, with the aim of reducing the risk of neoplastic progression.

Structured lifestyle guidance is also incorporated as part of the recommendation.

Complete protocol detail — including the specific agent, monitoring criteria, and decision algorithm — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1053/j.gastro.2025.09.012

In adult patients with BE, the AGA suggests the use of daily PPI therapy compared with no PPI therapy for the prevention of neoplastic progression of BE.
In patients with BE, the AGA suggests use of PPIs over surgery for the prevention of neoplastic progression to HGD or EAC.
In patients with BE, counsel tobacco cessation and weight loss if overweight or obese.

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