Even among top-tier gastroenterologists, how to best manage Barrett esophagus remains unsettled. A new Mayo Clinic–led survey of BE experts revealed striking inconsistencies — nearly half (47%) never offer ablation for nondysplastic Barrett’s, while 44% question biopsy diagnoses made by community gastroenterologists.
Despite updated guidelines, opinions diverged on everything from when to use radiofrequency ablation to how aggressively to surveil or treat reflux after surgery. While most agreed on ablation for low-grade dysplasia, many differed on diagnostic tools like WATS-3D and long-term proton pump inhibitor use.
The findings highlight a widening gap between evidence-based recommendations and real-world practice — even among specialists shaping BE care. As the authors note, aligning standards will require continued education and collaboration across the GI community.