Treatment of acid reflux

To the Editor: In Dr. Pope's thoughtful review of acid-reflux disorders (Sept. 8 issue),¹ endoscopy is considered to be indicated only in a patient who continues to have symptoms after antireflux treatment. Assuming that the purpose of endoscopy is to evaluate the degree of esophagitis and, possibly of greater importance, to rule out the presence of Barrett's esophagus, one could make a strong argument that patients who have a response to antireflux therapy are particularly good candidates for endoscopy. Because the metaplastic tissue in the distal esophagus in Barrett's syndrome can resemble gastric mucosal lining, there may be less sensitivity.  . .