Trujillo-Benavides OE, Baltazar-Montúfar P, Ángeles-Garay U, Ramírez-Mendoza P, Navarro-García AM, Paredes-Cruz E, Méndez MR, Guerrero-Hernández M

Language: Spanish
References: 24
Page: 14-19
PDF size: 51.58 Kb.

ABSTRACT

Background data: Barrett esophagus is a proximal displacement of the squamocolumnar junction relative to the gastroesophageal junction with intestinal metaplasia, it has been linked to gastroesophageal reflux disease. However, it has been observed in individuals without gastroesophageal reflux symptoms, with prevalence up to 25% in 50 years older men. Objective: Assess the association between symptomatic gastroesophageal reflux and Barrett’s esophagus. Methods: Consecutive patients undergoing endoscopy at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire for determining 2 groups (patients with and without gastroesophageal reflux symptoms). Those subjects with suggestive image of Barrett’s esophagus, biopsy specimens were obtained from the distal esophageal mucosa with the intention of find intestinal metaplasia. We compared prevalence of Barrett’s esophagus between groups. Results: One hundred and nine patients were studied. Prevalence of symptomatic gastroesophageal reflux disease was 37.6%. Barrett’s esophagus was found in 9.7% of symptomatic gastroesophageal reflux disease patients and in 9.6% of subjects without symptoms of gastroesophageal reflux disease (p = 0.87). Gender and age were similar between groups. Prevalence of hernia hiatal was bigger in patients with Barrett’s esophagus (90 vs. 42%) (p = 0.004). Conclusion: Our study didn’t show association between symptomatic gastroesophageal reflux detected by a questionnaire and Barrett’s esophagus.

REFERENCES

1. Sampliner RE. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. Am J Gastroenterol 1998; 93(7): 1028-32.

2. Cameron AJ. Epidemiology and genetics in Barrett’s esophagus: is there really ethnic predominance? AGA Postgraduate course 1999 May 15-16; 121-4.

3. Spechler ST. Barrett’s esophagus. N Engl J Med 2002; 346(11): 836-42.

4. Lagergren J, Bergström R, Lindgren A, Nyrén O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 1999; 340: 825-31.

5. Gerson LB, Shetler K, Triadafilopoulos G. Prevalence of Barrett’s esophagus in asymptomatic individuals. Gastroenterology 2002; 123: 461-7.

6. Winters Ch, Spurling TJ, Chobanian SJ, et al. Barrett’s esophagus. A prevalent, occult complication of gastroesophageal reflux disease. Gastroenterology 1987; 92: 118-24.

7. Lieberman DA, Oehlke M, Helfand M. And the George Consortium. Risk factors for Barrett’s esophagus in community-based practice. Am J Gastroenterol 1997; 92: 1293-7.

8. Fletcher J, Gillen D, Wirz A, McColl K. Barrett’s esophagus evokes a quantitatively and qualitatively altered response to both acid and hypertonic solutions. Am J Gastroenterol 2003; 98: 1480-6.

9. Koop H. Reflux disease and Barrett’s esophagus. Endoscopy 2000; 32: 101-7.

10. Rytzer P, Christensen PB, Damkier P, et al. Adenocarcinoma of the esophagus and Barrett’s esophagus: A population-based study. Am J Gastroenterol 1999; 94: 86-91.

11. Rex DK, Cummings OW, Shaw M, et al. Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn. Gastroenterology 2003; 125: 1670-7.

12. Carlsson R, Dent J, Bolling-Sternevald E, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998; 33: 1023-9.

13. Gómez-Escudero O, Remes-Troche JM, Ruiz JC, et al. Utilidad diagnóstica del cuestionario de Carlsson-Dent para enfermedad por reflujo gastroesofágico. Rev Gastroenterol Mex 2003; 68 Supl. 3: 87.

14. Falk GW. Barrett’s esophagus. Gastroenterology 2002; 122: 1569-91.

15. Bolúmar MF, Vioque LJ, Rebagliato RM. Estudios descriptivos ecológicos. Estudios transversales en: Gil P. (ed.). Medicina preventiva y salud pública. 10a. ed. Barcelona, España: Masson; 2001, p. 96-101.

16. Trujillo-Benavides OE, Castillo-Barradas M, García-Juárez J, et al. Prevalencia y perfil clínico de la enfermedad por reflujo gastroesofágico en una población abierta. Rev Gastroenterol Mex 2003; 68 Supl. 3: 123.

17. Sharma P, McQuaid K, Dent J, et al. A Critical Review of the diagnosis and management of Barrett’s esophagus: The AGA Chicago Workshop. Gastroenterology 2004; 127: 310-30.

18. Cameron AJ, Arora AS. Barrett’s esophagus and reflux esophagitis: is there a missing link? Am J Gastroenterol 2002; 97: 273-8.

19. Fass R. Epidemiology and pathophysiology of symptomatic gastroesophageal reflux disease. Am J Gastroenterol 2003; 98(No. 3 Suppl): S2-S7.

20. Tobey NA, Carson JL, Alkiek RA, Orlando RC. Dilated intercellular spaces: A morphological feature of acid reflux-damaged human esophageal epithelium. Gastroenterology 1996; 111: 1200-5.

21. Romero Y, Cameron AJ, McDonell SK, et al. Barrett’s esophagus: Prevalence in relatives with and without frequent symptoms. Gastroenterology 2001; 120(Suppl. 1): A410-11.

22. Cameron AJ. Barrett’s esophagus: prevalence and size of hernia hiatal. Am J Gastroenterol 1999; 94: 2054-9.

23. Uscanga L, Nogueira-de-Rojas JR, Gallardo E et al. y el Grupo Mexicano para el Estudio de la Enfermedad por Reflujo Gastroesofágico. Enfermedad por reflujo gastroesofágico. Resultados del consenso del Grupo Mexicano para el estudio de la ERGE. Rev Gastroenterol Mex 2002; 67(3): 216-23.

24. Sampliner RE. And the Practice Parameters Committee of the American College of Gastroenterology. Update guidelines for the diagnosis, surveillance, and therapy of Barrett’s esophagus. Am J Gastroenterol 2002; 97: 1888-95.