Is Barrett's esophagus characterized by more pronounced acid reflux than severe esophagitis?
OBJECTIVE
Barrett's esophagus is related to gastroesophageal reflux disease (GERD). However, only a small fraction of patients with GERD develop Barrett's esophagus. We evaluated whether gastroesophageal acid reflux is more pronounced in Barrett's patients than in patients with moderate or severe endoscopic esophagitis.


METHODS
Retrospective evaluation of results of esophageal manometry and 24 hour ambulatory pH monitoring performed between 1990 and 1996 at the Leiden University Medical Center in those patients who also underwent endoscopy < or = 3 months before pH-metry. Included were 51 patients with Barrett's esophagus, 30 patients with severe esophagitis, 45 patients with moderate esophagitis, and 24 healthy control subjects.


RESULTS
Patients with Barrett's esophagus had significantly increased acid reflux time (p < 0.01-0.05) compared to patients with moderate, but not compared to patients with severe esophagitis. Distal esophageal body motility and LES pressure were significantly (p < 0.01-0.05) reduced in patients with Barrett's esophagus compared to patients with moderate esophagitis but not compared to those with severe esophagitis.


CONCLUSIONS
Although acid reflux is increased in patients with Barrett's esophagus and esophageal motility is impaired, other factors apart from acid exposure and motility contribute to the development of Barrett's esophagus.
Coenraad
M
M
Department of Gastroenterology-Hepatology, Leiden University Medical Center, The Netherlands.
Masclee
A A
AA
Straathof
J W
JW
Ganesh
S
S
Griffioen
G
G
Lamers
C B
CB
D000704:Analysis of Variance; D001471:Barrett Esophagus / Q000209:etiology* / Q000503:physiopathology; D016002:Discriminant Analysis; D004941:Esophagitis / Q000209:etiology* / Q000503:physiopathology; D004943:Esophagogastric Junction / Q000503:physiopathology; D004945:Esophagoscopy; D004947:Esophagus / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D005260:Female; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D010528:Peristalsis / Q000502:physiology; D011312:Pressure; D012189:Retrospective Studies; D013997:Time Factors