<prompt> All are true about Barretts esophagus, EXCEPT:Specialised columnar metaplasiaMajor risk factor for adenocarcinoma esophagusScreening endoscopy is required in all patients with GERD symptomsEndoscopic biopsy is the gold standard for confirmation  <response>: Barretts Esophagus: 1. Barretts esophagus is specialized columnar metaplasia that replaces the normal squamous mucosa of the distal esophagus. 2. It is a major risk factor for adenocarcinoma of the esophagus and is readily detected endoscopically. 3. A screening endoscopy for Barretts esophagus may be considered in patients with a chronic history 10 year of GERD symptoms. 4. Endoscopic biopsy is the gold standard for confirmation of Barretts esophagus. ALSO KNOW: Endoscopic therapies such as endoscopic mucosal resection EMR, endoscopic submucosal dissection ESD, photodynamic therapy PDT, and radiofrequency ablation RFA are effective modalities for treatment of high-grade dysplasia and intramucosal cancer in Barretts esophagus. Ref: Harrison, Edition-18, Page-2419. 