Barretts esophagus (BE) is defined as columnar metaplasia of the esophagus a premalignant condition where the esophageal squamous epithelium undergoes columnar changes with metaplasia which predisposes to the development of esophageal adenocarcinoma. Patients with BE are at increased risk for adenocarcinoma which develops in a metaplasia-dysplasia-carcinoma sequence. The definition of BE is still presently a worldwide controversy mainly concerning the diagnostic criteria of BE which histologically requires identifying goblet cells in biopsies. This review focuses on potential key regulators, epigenetic alterations, answer questions on the various controversial issues surrounding the definition, pathogenesis, histopathology, molecular biology, clinical aspects, surveillance, treatments, complications, management of dysplasia and early cancer. As a comprehensive review, it impartially systemizes knowledge from a large number of highly significant publications which describes the molecular and biochemical alterations occurring over BE progression sequence involving multidisciplinary subject from epidemiology, biomarkers, genomics/genetics, gastroenterology, gastrointestinal surgery, and endoscopic therapy.
Key words: Barretts esophagus, esophageal adenocarcinoma, Gastroesophageal reflux disease, Pathophysiology, Ablative techniques, Surveillance