PAEA Surgery End Of Rotation (EOR) Practice Exam

What can be a potential long-term consequence of untreated esophageal reflux?

1. Weight loss

2. Barrett's esophagus

3. Peptic ulcers

4. Gastric cancer

The correct answer is: Barrett's esophagus

Barrett's esophagus is recognized as a significant long-term consequence of untreated gastroesophageal reflux disease (GERD). In this condition, the normal squamous cells lining the esophagus undergo a transformation into columnar cells, which is referred to as intestinal metaplasia. This change is a result of chronic exposure to stomach acid due to reflux, leading to alterations in the cellular structure of the esophagus. The relevance of Barrett's esophagus lies in its association with an increased risk of developing esophageal adenocarcinoma, a form of cancer that can arise from this metaplastic change. The risk of progression from Barrett's esophagus to cancer is significant, especially in individuals with long-standing GERD. Regular surveillance and monitoring are often recommended for patients diagnosed with Barrett's esophagus to detect any potential progression toward malignancy. While weight loss, peptic ulcers, and gastric cancer can also be related to gastrointestinal conditions, they are not direct consequences of untreated esophageal reflux in the same way that Barrett's esophagus is. Weight loss may occur in cases of severe esophageal pain or dysphagia but is not a consistent consequence of reflux itself. Peptic ulcers are generally associated with other factors, such as H. pylori infection