Barrett's Esophagus: Prevalence and its Relationship With
Barrett's Esophagus: Prevalence and its Relationship With
Background and Aim: Barrett's metaplasia is a premalign condition which plays a pivotal role in the development of esophageal adenocarcinoma. It is considered a complication of chronic gastroesophageal reflux disease. Although esophageal adenocarcinoma is an uncommon cancer, its incidence is rapidly increasing. The aims of the present study were to determine the prevalence of Barrett's metaplasia in outpatients referred for gastroscopy for upper gastrointestinal symptoms, and to clarify the relationship between Barrett's metaplasia and upper gastrointestinal symptoms.
Methods: Three-hundred and ninety-five consecutive dyspeptic patients, never previously investigated, underwent gastroscopy and were enrolled into the study.
Results: Barrett's metaplasia was detected in 29 patients (7.4%). The age-specific prevalence of Barrett's metaplasia increased with age. In multivariate analysis, Barrett's metaplasia was independently and positively related to age, sex and duration of symptoms, but not with upper gastrointestinal symptoms. In univariate analysis, Barrett's metaplasia was significantly more common in patients with antral intestinal metaplasia (24%) and presence of hiatal hernia (65.5%), compared with those with normal endoscopic findings (6.2% and 39.2%, respectively, p = 0.001).
Conclusion: Symptoms do not predict Barrett's metaplasia. Barrett's metaplasia is age-related and more common in patients with a longer duration of symptoms, presence of hiatal hernia and antral intestinal metaplasia.
Barrett's esophagus (BE) is a metaplastic change of the lining of the esophagus with replacement of the normal squamous epithelium with columnar epithelium containing goblet cells. It is the most severe histological consequence of chronic gastroesophageal reflux and predisposes to the development of adenocarcinoma of the esophagus. As increases in the incidence of esophageal adenocarcinoma have been reported in Western countries such as the USA, New Zealand, Australia and western European countries in recent years, interest in the prevalence of BE and its predicting factors has increased. Barrett's esophagus is usually discovered during endoscopic examination of middle-aged and older adults whose mean age at the time of diagnosis is approximately 55 years. Series of surgical resections of adenocarcinoma of the esophagus associated with BE reveal that it is overwhelmingly predominate in white males. The columnar metaplasia in BE causes no symptoms. Thus, patients are seen initially for symptoms of the associated gastroesophageal reflux disease (GERD), such as heartburn and regurgitation. Endoscopically obvious BE can be seen in approximately 10% of patients who have endoscopic examinations for symptoms of GERD. However, approximately 25% of patients have no esophageal symptoms. Additionally, there are data suggesting that the duration of reflux symptoms significantly correlates with the prevalence of BE. In this setting, BE is discovered during endoscopic examinations performed for unrelated conditions.
The epidemiology of BE is incompletely described. In recent years, by definition of short segment Barrett's esophagus (SSBE), an increase in the prevalence of BE has been detected. In a study from the USA, BE was detected in 25% of asymptomatic male veterans older than 50 years undergoing screening sigmoidoscopy for colorectal cancer. In another study from Japan, BE was detected in 15.7% of individuals who underwent an upper gastrointestinal endoscopy for the evaluation of BE.
The aims of the present study were to investigate the prevalence of BE in a group of patients who had undergone gastroscopy due to dyspeptic symptoms, and to determine the relationship between BE and these symptoms.
Background and Aim: Barrett's metaplasia is a premalign condition which plays a pivotal role in the development of esophageal adenocarcinoma. It is considered a complication of chronic gastroesophageal reflux disease. Although esophageal adenocarcinoma is an uncommon cancer, its incidence is rapidly increasing. The aims of the present study were to determine the prevalence of Barrett's metaplasia in outpatients referred for gastroscopy for upper gastrointestinal symptoms, and to clarify the relationship between Barrett's metaplasia and upper gastrointestinal symptoms.
Methods: Three-hundred and ninety-five consecutive dyspeptic patients, never previously investigated, underwent gastroscopy and were enrolled into the study.
Results: Barrett's metaplasia was detected in 29 patients (7.4%). The age-specific prevalence of Barrett's metaplasia increased with age. In multivariate analysis, Barrett's metaplasia was independently and positively related to age, sex and duration of symptoms, but not with upper gastrointestinal symptoms. In univariate analysis, Barrett's metaplasia was significantly more common in patients with antral intestinal metaplasia (24%) and presence of hiatal hernia (65.5%), compared with those with normal endoscopic findings (6.2% and 39.2%, respectively, p = 0.001).
Conclusion: Symptoms do not predict Barrett's metaplasia. Barrett's metaplasia is age-related and more common in patients with a longer duration of symptoms, presence of hiatal hernia and antral intestinal metaplasia.
Barrett's esophagus (BE) is a metaplastic change of the lining of the esophagus with replacement of the normal squamous epithelium with columnar epithelium containing goblet cells. It is the most severe histological consequence of chronic gastroesophageal reflux and predisposes to the development of adenocarcinoma of the esophagus. As increases in the incidence of esophageal adenocarcinoma have been reported in Western countries such as the USA, New Zealand, Australia and western European countries in recent years, interest in the prevalence of BE and its predicting factors has increased. Barrett's esophagus is usually discovered during endoscopic examination of middle-aged and older adults whose mean age at the time of diagnosis is approximately 55 years. Series of surgical resections of adenocarcinoma of the esophagus associated with BE reveal that it is overwhelmingly predominate in white males. The columnar metaplasia in BE causes no symptoms. Thus, patients are seen initially for symptoms of the associated gastroesophageal reflux disease (GERD), such as heartburn and regurgitation. Endoscopically obvious BE can be seen in approximately 10% of patients who have endoscopic examinations for symptoms of GERD. However, approximately 25% of patients have no esophageal symptoms. Additionally, there are data suggesting that the duration of reflux symptoms significantly correlates with the prevalence of BE. In this setting, BE is discovered during endoscopic examinations performed for unrelated conditions.
The epidemiology of BE is incompletely described. In recent years, by definition of short segment Barrett's esophagus (SSBE), an increase in the prevalence of BE has been detected. In a study from the USA, BE was detected in 25% of asymptomatic male veterans older than 50 years undergoing screening sigmoidoscopy for colorectal cancer. In another study from Japan, BE was detected in 15.7% of individuals who underwent an upper gastrointestinal endoscopy for the evaluation of BE.
The aims of the present study were to investigate the prevalence of BE in a group of patients who had undergone gastroscopy due to dyspeptic symptoms, and to determine the relationship between BE and these symptoms.
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