Defining the Esophagogastric Junction in the Presence of Barrett's Esophagus: Considerations and Alternative Endoscopic Reference Points

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In the presence of Barrett's esophagus, the native squamocolumnar junction, which marks the transition between squamous and columnar epithelium, is replaced by specialized intestinal metaplasia. Therefore, using the squamocolumnar junction as a reference point to define the esophagogastric junction is not applicable in cases of Barrett's esophagus. Instead, when Barrett's esophagus is present, the esophagogastric junction can be defined endoscopically as the proximal margin of the gastric mucosal folds. This reference point helps in identifying the location of the junction during endoscopic evaluations and procedures. It is important to consider the specific circumstances and conditions of each patient, and a healthcare professional experienced in endoscopy should provide accurate assessments and interpretations of these anatomical landmarks