Many gastroenterologists encounter patients with subtle tongues of salmon-colored mucosa or an irregular Z-line that is biopsied, but guidelines disagree on whether segments <1 cm should be labeled as BE or followed at all. Some societies exclude USBE due to measurement variability and presumed minimal cancer risk. This study provides long-term outcome data to help clinicians understand whether USBE is clinically meaningful, challenging the assumption that these short segments are benign and transient.

The addition of bedtime lafutidine 10 mg to esomeprazole 20 mg twice daily significantly increased nocturnal intragastric pH >4 holding time ratios and decreased the occurrence of nocturnal acid breakthrough. GERD patients who added lafutidine experienced a more pronounced improvement in sleep quality, correlated with a reduction in nocturnal acid breakthrough. This bolsters existing ACG clinical guidelines for newer-generation H2RAs.

In this study, patients with proximal predominant eosinophilia were less likely to have a histologic response to proton pump inhibitors compared with those with distal predominant eosinophilia, and may provide prognostic information regarding treatment response.

ELP is a rare and under-recognized condition that presents significant diagnostic and therapeutic challenges, especially for gastroenterologists who often encounter these patients first. There is no consensus on diagnostic criteria or standard treatment, and existing histologic scoring systems are often impractical for routine use due to variability and nonspecific findings. This study introduces a visually based severity score (ELPSS) tailored for endoscopic use—similar to scoring tools in eosinophilic esophagitis—and highlights the potential of low-dose oral tacrolimus as a safe and effective treatment option for patients with moderate to severe ELP. Addressing this unmet need may improve disease recognition and long-term management.

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