The Microenvironment in Barrett's Esophagus

The investigators will perform a multi-center cross-sectional study of patients with Barrett's esophagus, with and without associated dysplasia or cancer, and controls without BE. Enrollment of controls will be stratified based on use of proton pump inhibitors (PPIs). The investigators plan to enroll an approximate total of 150 subjects:

100 BE patients (with or without associated dysplasia or cancer)

• 50 subjects with non-dysplastic BE
• 50 subjects with BE and dysplasia or EAC

50 controls

• 25 controls on PPIs (at least once daily)
• 25 controls not taking PPIs

Various tests will be performed and samples collected on the day of endoscopy. These tests include: saliva samples, electronic nose device testing, tethered capsule sponge testing, dietary questionnaires, and collection of blood and gastrointestinal biosamples. Analyses of this data and samples will then be performed to address the specific aims above.

Inclusion criteria

(for BE patients)

• History of histologically confirmed BE, defined as endoscopically-suspected BE with intestinal metaplasia with goblet cells on esophageal biopsies
• BE length M≥2
• Taking proton pump inhibitors at least once daily for 3 months prior to enrollment
• Age ≥18

Exclusion criteria

• History of gastric cancer or esophageal squamous cell cancer
• History of gastric or esophageal surgery
• Use of antibiotics or systemic immunosuppressants within three months prior to the date of endoscopy (intranasal and inhaled steroids are allowed)
• Known untreated esophageal stricture or uninvestigated dysphagia
• Inability to give informed consent
• (BE patients only) History of prior endoscopic therapy for BE except a history of prior endoscopic mucosal resection (EMR) of focal lesions without subsequent ablative therapy is permitted