Prevalence of short segments of specialized columnar epithelium in distal esophagus: association with gastroesophageal reflux.
OBJECTIVE
Recent studies have reported high prevalence rates of short segments of specialized columnar epithelium (SCE) in the distal esophagus. The association of SCE with gastroesophageal reflux disease is not well established. We studied the prevalence and associations of short segments of SCE in the distal esophagus amongst Indians.


METHODS
271 patients (mean age 36 [14] y; 160 men) undergoing diagnostic upper gastrointestinal endoscopy were interviewed regarding symptoms of gastroesophageal reflux, and history of medications, smoking or chewing tobacco and alcohol ingestion. At endoscopy, presence and grade of esophagitis and hiatus hernia were recorded. One biopsy each was taken from the squamocolumnar junction and 2 cm proximal to it. Biopsies were stained with hematoxylin/eosin and alcian blue/periodic acid-Schiff. The pathologist was blinded to the clinical and endoscopic data.


RESULTS
Short segments of SCE in the distal esophagus were present in 16/271 (6%; CI 5.03-6.97) patients. Increasing age (p<0.01), and endoscopic (p<0.01) and histologic (p<0.001) esophagitis were associated with its presence, whereas symptoms of gastroesophageal reflux, smoking, tobacco chewing, use of alcohol or non-steroidal anti-inflammatory drugs, and hiatus hernia were not. One patient with SCE had dysplasia.


CONCLUSIONS
Prevalence of short segments of SCE in the distal esophagus amongst Indians is low and is usually associated with inflammation in the esophagus.
Dhawan
P S
PS
Department of Gastroenterology, B Y L Nair Hospital and T N Medical College, Mumbai.
Alvares
J F
JF
Vora
I M
IM
Joseph
T K
TK
Bhatia
S J
SJ
Amarapurkar
A D
AD
Parikh
S S
SS
Kulkarni
S G
SG
Kalro
R H
RH
D000328:Adult; D000368:Aged; D000423:Alcian Blue; D001471:Barrett Esophagus / Q000209:etiology; D016001:Confidence Intervals; D004724:Endoscopy; D004947:Esophagus / Q000737:chemistry* / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010503:Periodic Acid-Schiff Reaction / Q000379:methods; D015995:Prevalence
D000423:Alcian Blue