Not really my thing since I only do adult GI, but Barrett's is primarily a disease of middle-aged adults and is unusual in children. In the past, diagnosis was based on endoscopic appearance but now requires the pathologic result you describe (metaplasia). It sounds like your 13 year old was appropriately diagnosed.
The risk of adenocarcinoma is significant, even in children, and though the studies are a bit unclear, to me the minimal risks associated with ppi use are outweighed by the potential for cancer prevention. Of course that assessment may be a bit different for a child. Of course if symptoms are not controlled by an H2 blocker and anti-reflux maneuvers, that would be even more reason to use a ppi.
Happy 4th everyone!
