Barrett esophagus is best described as ...

• A. Metaplastic squamous epithelium in the distal esophagus with minimal cancer risk
• B. Metaplastic epithelium displaces normal squamous epithelium of the distal esophagus and can lead to adenocarcinoma
• C. Inflammation of the esophagus due to acid reflux without metaplasia
• D. Benign ulcerative changes in the distal esophagus

Answer: (B)

Barrett esophagus occurs when chronic acid exposure from reflux causes the distal esophagus to lose its normal squamous lining and be replaced by intestinal-type columnar epithelium with goblet cells. This metaplastic tissue displaces the native squamous mucosa and carries an increased risk of progressing to dysplasia and esophageal adenocarcinoma. The description in the option matches both the histologic change and its cancer risk. It’s not simply inflammation without metaplasia, nor is it just benign ulceration or squamous metaplasia with minimal risk.