title: [Specialized intestinal metaplasia of the distal esophagus in gastroesophageal reflux disease: prevalence and clinico-demographic features].
abstract: BACKGROUND
  Specialized intestinal metaplasia can be categorized according endoscopic and histological findings in long segment Barrett, short segment Barrett and specialized intestinal metaplasia of cardia. Barrett's esophagus is an acquired disease that is found in about 10%-13% of patients undergoing endoscopy for symptoms of gastroesophageal reflux disease and it is well established as predisposing to esophageal adenocarcinoma. The columnar epithelium with goblet cells replaces the normal squamous epithelium.
  
  
  OBJECTIVE
  To determine the prevalence and clinical-demographic characteristics of specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease.
  
  
  METHODS
  From April to October 2002, 402 patients referred to upper endoscopy due gastroesophageal reflux disease were evaluated through of a symptom questionnaire about clinical and demographic features and submitted to upper endoscopy with four-quadrant biopsies 1 cm below escamocolumnar junction.
  
  
  RESULTS
  Eighteen point four percent of patients had specialized intestinal metaplasia, 0.5% long segment Barrett esophagus, 3.2% short segment Barrett's esophagus and 14.7% specialized intestinal metaplasia of cardia. Patients with Barrett's esophagus showed a tendency to be male and specialized metaplasia of cardia to be female. All patients with Barrett's esophagus were white. There was not association between symptoms of gastroesophageal reflux disease and specialized intestinal metaplasia, but patients with Barrett's esophagus showed a tendency to have symptoms over 5 years and had more hiatal hernia and esophagitis. The use of alcohol and tobacco was not related to the presence of specialized intestinal metaplasia.
  
  
  CONCLUSIONS
  Barrett's esophagus was more related to the male gender, gastroesophageal reflux disease symptoms for 5 years or longer, more intense esophagitis and hiatal hernia, but was not related to the use of tobacco and alcohol.
authors.affiliation: Hospital de Clínicas, Universidade Federal do Paraná. lrcaum7@bol.com.br
authors.forename: Leiber C
authors.initials: LC
authors.lastname: Caum
authors.forename: Sérgio L
authors.initials: SL
authors.lastname: Bizinelli
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Pisani
authors.forename: Heda Maria Barska dos Santos
authors.initials: HM
authors.lastname: Amarantes
authors.forename: Sérgio O
authors.initials: SO
authors.lastname: Ioshii
authors.forename: Eliane R
authors.initials: ER
authors.lastname: Carmes
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000473:pathology; D001938:Brazil / Q000453:epidemiology; D002299:Cardia / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008679:Metaplasia / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013272:Stomach Diseases / Q000453:epidemiology / Q000473:pathology