What cytological change occurs in Barrett’s esophagus?

In Barrett's esophagus, the key cytological alteration that occurs is intestinal metaplasia. This condition arises when the normal squamous epithelium of the esophagus is replaced by a columnar epithelium that resembles that of the intestine. This transformation is typically triggered by chronic injury, commonly due to gastroesophageal reflux disease (GERD), where the acidic gastric contents lead to changes in the esophageal lining.

The presence of intestinal metaplasia indicates an adaptation to the adverse conditions in the esophagus, allowing for more resilient columnar cells to withstand the harsh environment. This metaplastic change is significant because it is associated with an increased risk of esophageal adenocarcinoma.

Other options, while they represent different histopathological changes or phenomena, do not accurately depict the primary cytological alteration associated with Barrett's esophagus. For instance, a reduction in squamous cells might be observed as a result of metaplasia, but it does not define the condition itself. Keratinization of the esophageal epithelium does not occur in Barrett’s; rather, the normal keratinized squamous cells are replaced by non-keratinized or columnar cells during metaplasia