Snapshot A 52-year-old man presents to the emergency room with chest pain. He denies any pain with physical exertion. He just had a large, fatty, spicy meal. His cardiac work-up is negative. He has had GERD for the past ten years now but recently developed increasing heartburn and regurgitation. His BMI is 31 kg/m2. His emergency room physician recommends that he continue using proton pump inhibitors and schedules an outpatient primary care appointment for him. In a note to his PCP, he suggests a screening endoscopy. Introduction Metaplastic transformation of esophageal lining login to view 3 more bullets Result of chronic gastroesophageal reflux disease (GERD) Risk factors login to view 5 more bullets Associated conditions login to view 1 more bullet ETIOLOGY Pathogenesis login to view 2 more bullets Presentation Symptoms login to view 2 more bullets Physical exam login to view 1 more bullet STUDIES Diagnosis with upper endoscopy with biopsy showing both login to view 3 more bullets Differential Diagnosis Erosive esophagitis Gastritis Treatment Lifestyle modifications login to view 2 more bullets Proton pump inhibitor for GERD Endoscopic surveillance login to view 5 more bullets Surgical intervention for prevention of cancer with unclear benefits Complications Progression to adenocarcinoma Ulceration leading to stricture formation Prognosis ↑ lifetime risk of esophageal cancer login to view 2 more bullets ↑ annual risk of esophageal cancer in Barrett's esophagus login to view 1 more bullet