From the Guidelines

Barrett's esophagus is reversible with certain treatments, particularly Radiofrequency Ablation (RFA).

The goal of endoscopic eradication therapy is to eliminate all Barrett's epithelium and achieve a complete reversion to squamous epithelium 1.
RFA has been shown to lead to reversion of the metaplastic mucosa to normal-appearing squamous epithelium in a high proportion of subjects at any stage of Barrett's esophagus, with data showing that reversion to squamous epithelium can persist for up to 5 years 1.
RFA therapy for patients with low-grade dysplasia leads to reversion to normal-appearing squamous epithelium in 90% of cases, and for patients with high-grade dysplasia, reduces progression to esophageal cancer 1.

Current endoscopic techniques used to eradicate Barrett's esophagus include RFA, Photodynamic Therapy (PDT), cryotherapy, thermal energy application, and Endoscopic Mucosal Resection (EMR) 1.
RFA appears to have a better safety profile and is easier to administer compared to PDT, and has been associated with a lower incidence of buried glands than Argon Plasma Coagulation (APC) 1.

The risk of cancer in areas of Barrett's esophagus treated with ablative therapy remains unclear, and there have been reports of adenocarcinoma developing beneath squamous mucosa in areas of apparent reversion to squamous epithelium 1.
Treatment of Barrett's esophagus patients with high doses of acid suppressants solely in the hope of decreasing the risk of adenocarcinoma is of no proven value 1.

From the Research

Barrett's esophagus is a metaplastic change in the esophageal lining with an increased risk for adenocarcinoma, and its reversibility has been explored in various studies 2, 3.
A study published in 2001 found that 85% of patients with nondysplastic Barrett's esophagus had visual reversal, and 78% had both visual and histologic reversal after treatment with multipolar electrocoagulation combined with high-dose acid inhibition 3.
Another study published in 2014 suggested that metaplasia is a potentially reversible condition, and partial regression of Barrett's metaplasia has been documented with effective medical or surgical therapy for GERD 2.
However, the current guidelines and recommendations for the diagnosis and management of Barrett's esophagus do not provide a clear answer on its reversibility, and more research is needed to determine the effectiveness of different treatments 4, 5.

The mainstay of treatment for nondysplastic Barrett's esophagus consists of a healthy lifestyle change, chemoprevention with proton pump inhibitors, and surveillance endoscopy every 3 to 5 years 5.
For patients with low-grade dysplasia, referral to an expert center for confirmation of the diagnosis, stage, and management is recommended 5.
Endoscopic therapy with resection and ablation is successful in about 90% of patients with Barrett's esophagus and dysplasia or early-stage cancer, but the main adverse event is esophageal stricture, which is managed endoscopically 5.

The main risk factors for esophageal adenocarcinoma associated with Barrett's esophagus are male sex, age > 50 years, central obesity, and tobacco use 5.
Annual risk of esophageal adenocarcinoma in patients with Barrett's esophagus without dysplasia, low-grade dysplasia, and high-grade dysplasia is 0.1-0.3%, 0.5%, and 5-8%, respectively 5.
Proton pump inhibitors may prevent cancer in Barrett's esophagus by healing reflux esophagitis, reducing exposure to a potential carcinogen, and preventing acid-induced proliferation and cancer-promoting cytokine secretion by esophageal epithelial cells 2.