Is there dysplasia?
The key issue with barrett's is whether there is any dysplasia .
Dysplasia is an abnormality of the cells of the esophagus that have a distinct microscopic appearance. High-grade dysplasia (hgd) requires rx (surgical or endoscopic); low-grade dysplasia (lgd) warrants very close surveillance. Ironically, anti-reflux surgery has not led to a regression in barrett's changes as one would think.