American Board of Family Medicine (ABFM) Practice Exam

What is a potential complication of untreated Barrett's esophagus?

1. Esophageal stricture

2. Barrett's dysplasia

3. Gastroesophageal reflux disease

4. Pneumonia

The correct answer is: Barrett's dysplasia

Barrett's esophagus is a condition where the normal squamous cells lining the esophagus are replaced with columnar cells due to chronic gastroesophageal reflux disease (GERD). One of the significant risks associated with Barrett's esophagus is the progression to dysplasia, which refers to the presence of abnormal cells and indicates a precancerous condition. When Barrett's esophagus is left untreated, the abnormal cells can accumulate further genetic changes, resulting in Barrett's dysplasia. This dysplasia is classified into low-grade and high-grade dysplasia, with high-grade dysplasia being a strong predictor of an increased risk for esophageal adenocarcinoma, a type of esophageal cancer. The progression from Barrett’s esophagus to dysplasia is a major concern for patients and underscores the importance of regular monitoring and possible treatment to mitigate this risk. In contrast, while esophageal strictures and GERD are associated with Barrett’s esophagus, they do not arise as directly from the untreated condition itself. Pneumonia is not a recognized complication of Barrett's esophagus. Thus, Barrett's dysplasia stands out as the most significant potential complication of untreated Barrett's esophagus, as it leads to serious repercussions like esophageal cancer.