[Endoscopic therapy of Barrett esophagus--a supplement to drug and surgical options?].

Within the last few years intestinal metaplasia at the gastroesophageal junction (Barrett's esophagus) has turned out to be a "shooting star" in the field of gastrointestinal diseases. The detection rate of Barrett's epithelium by the endoscopists and pathologists has raised dramatically as well as the incidence of the carcinoma at the gastroesophageal junction. Furthermore the "short Barrett" was discovered as a relevant risk factor for cancer development. To date ablation techniques with thermal devices, photodynamic techniques (PDT) and the mucosal resection (EMR) compete as local endoscopic treatment methods. However to date it is still in discussion whether in case of nondysplastic Barrett's esophagus endoscopic therapy is an "overtreatment" and an "undertreatment" in case of Barrett's with high-grade dysplasia or early cancer. The currently available data are discussed.