PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a notable risk factor for developing Barrett's esophagus?

1. Obesity

2. Smoking

3. Chronic gastroesophageal reflux

4. High alcohol consumption

The correct answer is: Chronic gastroesophageal reflux

Barrett's esophagus is a condition that arises when the lining of the esophagus is damaged, often due to chronic gastroesophageal reflux disease (GERD). This condition, characterized by the backflow of stomach acids into the esophagus, leads to inflammation and changes in the cellular structure of the esophagus. Over time, persistent exposure to these acid attacks can result in the transformation of normal squamous epithelial cells into columnar cells, which is known as intestinal metaplasia. This metaplasia is a precancerous change that can increase the risk of developing esophageal adenocarcinoma. While obesity, smoking, and high alcohol consumption can contribute to an increased risk for GERD and subsequently Barrett's esophagus, the direct and most notable risk factor for Barrett's esophagus is indeed chronic gastroesophageal reflux. Identifying and managing GERD effectively is crucial in preventing the progression to Barrett's esophagus and its associated complications. Understanding the mechanisms of reflux and its relationship to cellular changes helps healthcare professionals intervene early to protect patients at risk.