title: [Biopsy and endoscopic prospective study of the prevalence of intestinal metaplasia in the gastroesophageal junction in controls and in patients with gastroesophageal reflux].
abstract: BACKGROUND
  The classic diagnosis of Barret esophagus is based on the finding of three of more cm of distal esophagus covered by specialized columnar epithelium. However, at the present time, it is based on the presence of intestinal metaplasia in the junction of squamous-columnar mucosae.
  
  
  OBJECTIVE
  To assess the prevalence of Barret esophagus using endoscopic and pathological criteria in healthy subjects and in individuals with gastroesophageal reflux.
  
  
  METHODS
  One hundred thirty nine controls and 372 patients with symptoms of gastroesophageal reflux subjected to an upper gastrointestinal endoscopy were studied. Patients with Barret esophagus were classified as having a "mini Barret" when the pathological presence of intestinal metaplasia was the only finding. A "short Barret esophagus" was diagnosed when less than 3 cm were covered with fingerings of mucosal substitutions and "extensive Barret esophagus" when more than 3 cm of esophageal mucosa were substituted.
  
  
  RESULTS
  Two percent of controls, 12.4% of patients with gastroesophageal reflux without esophagitis and 11.7% of such patients with esophagitis had intestinal metaplasia in the gastroesophageal junction. Patients with Barret esophagus were older than the rest of patients. "Short Barret esophagus" is six times more frequent than "extensive Barret esophagus". Esophageal erosions, peptic ulcers and stenosis were more frequent in patients with extensive Barret esophagus. The prevalence of dysplasia was similar in all types of Barret esophagus.
  
  
  CONCLUSIONS
  Intestinal metaplasia was very infrequent in control patients. In subjects with gastroesophageal reflux, classic endoscopic diagnosis may miss up to 80% of patients with Barret esophagus. Thus, gastroesophageal junction biopsies must be obtained in all patients with symptoms of gastroesophageal reflux.
authors.affiliation: Departamento de Cirugía, Hospital Clínico, Universidad de Chile, Santiago, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Csendes
authors.forename: G
authors.initials: G
authors.lastname: Smok
authors.forename: H
authors.initials: H
authors.lastname: Sagastume
authors.forename: J
authors.initials: J
authors.lastname: Rojas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies
vernacular_title: Estudio prospectivo endoscópico y biópsico de la prevalencia de metaplasia intestinal en la unión gastro-esofágica en controles y en pacientes con reflujo gastroesofágico.