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This is a study of the overall frequency of the development of adenocarcinoma of the esophagus in patients with Barrett's esophagus. Patients with documented Barrett's esophagus are followed with regular interval endoscopy and biopsy. The effort is to better define the incidence of adenocarcinoma of the esophagus and the specific risk factors for this cancer. Special biopsies are taken at each endoscopy in an effort to identify markers that will help us to predict more accurately the risk of an individual for the development of cancer.
In this study a high dose acid blocking agent is provided to the patient and patients are then randomized to two different types of endoscopic therapy to eliminate their Barrett's esophagus. One therapy is called multipolar electrocoagulation (MPEC) - cauterizing the esophagus. The other therapy is argon plasma coagulation (APC) - another form of heat injury to the esophagus. Both of these methods have been documented to be capable of eliminating Barrett's esophagus. The purpose of this study is to see which method is more effective, can be achieved in fewer treatment sessions and has fewer side effects.