What is the most likely cause of these findings?

A 46 year old man complains of having heartburn for many years, but had previously never consulted a physician. There are no findings on physical exam. An upper GI endoscopy is performed and esophageal biopsy is taken from an area of velvety mucosa above the gastroesophageal junction. Pathology shows columnar metaplasia with goblet cells. What is the most likely cause of these findings?

1.Achalasia
2.Esohageal varices
3.GERD
4.Iron deficiency anemia
5. Radiation therapy

Solution

This patient has Barrett esophagus which is columnar metaplasia of the lower esophageal mucosa is often a consequence of gastroesophageal reflux disease. One third of patients with Barrett’s develop esophageal cancer.