[Clinical and endoscopic findings and magnitude of gastric and duodenal reflux in patients with cardial intestinal metaplasia, short Barrett esophagus, compared with controls].
BACKGROUND
The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years.


OBJECTIVE
To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia.


METHODS
A prospective study was performed in 95 control subjects, 115 patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia. All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content.


RESULTS
Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa. In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia.


CONCLUSIONS
These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia.
Csendes
A
A
Departamento de Cirugía, Hospital Clínico de la Universidad de Chile.
Burdiles
P
P
Smok
G
G
Rojas
J
J
Flores
N
N
Domic
S
S
Quiroz
J
J
Henríquez
A
A
D001471:Barrett Esophagus / Q000175:diagnosis* / Q000209:etiology; D002299:Cardia / Q000473:pathology*; D004383:Duodenogastric Reflux / Q000150:complications / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies