Reply to Schoppman et al.

We were delighted to read the interesting letter from Professor Schoppman and colleagues. They raise two issues: pre-emptive endoscopic radiofrequency ablation (RFA) to prevent development of esophageal adenocarcinoma (EAC); and the link between Barrett’s esophagus, cardiorespiratory illness, and metabolic syndrome.

In our cohort [1], 24 % died during follow-up, and of those 16 % died from EAC, compared with 34 % from cardiovascular causes. Overall mortality was higher than expected but only due to EAC.

• References

• 1 Caygill CPJ, Royston C, Charlett A et al. Mortality in Barrett’s esophagus: three decades of experience at a single center. Endoscopy 2012; 44: 892-898
• 2 Spechler SJ. Barrett’s esophagus without dysplasia: wait or ablate?. Dig Dis Sci 2011; 56: 1926-1928
• 3 Sikkema M, Looman CWN, Steyerberg EW et al. Predictors for neoplastic progression in patients with Barrett’s esophagus: a prospective cohort study. Am J Gastroenterol 2011; 106: 1231-1238
• 4 Caygill CPJ, Royston C, Charlett A et al. Barrett’s, blood groups and progression to oesophageal cancer: is nitric oxide the link?. Eur J Gastroenterol Hepatol 2011; 23: 801-806
• 5 Bardhan KD, Strugala V, Dettmar PW. Reflux revisited: advancing the role of pepsin. Int J Otolaryngol 2012; 646901 Epub 2011 Nov 10