The prevalence of Barrett's oesophagus in a cohort of 1040 Canadian primary care patients with uninvestigated dyspepsia undergoing prompt endoscopy.
BACKGROUND
The prevalence of Barrett's oesophagus in patients undergoing gastroscopy may be influenced by possible referral bias.


OBJECTIVE
To present the prevalence of Barrett's oesophagus from the the Canadian Adult Dyspepsia Empirical Therapy Prompt Endoscopy study and to explore potential risk factors for its presence.


METHODS
Patients had not been on treatment for dyspepsia for 2-4 weeks prior to endoscopy, which was performed within 10 working days of presentation.


RESULTS
Barrett's oesophagus was endoscopically suspected in 53 of 1040 cases (5%) and histologically confirmed by the presence of intestinal metaplasia in 25 (2.4%). The prevalence of biopsy-proven Barrett's oesophagus was 4% in patients with dominant reflux-like symptoms. Sixty-four percent with confirmed Barrett's oesophagus had dominant reflux-like symptoms compared with 37% without Barrett's oesophagus. Barrett's oesophagus was more common in patients >50 years of age; 68% of cases were males. The mean duration of symptoms was 10 years, yet 16% had symptoms of <1-year duration. Endoscopic reflux oesophagitis was present in 68% of confirmed Barrett's oesophagus patients.


CONCLUSIONS
Barrett's oesophagus is confirmed on biopsy in about half of endoscopically suspected Barrett's oesophagus patients. Barrett's oesophagus is more common in males, in those with dominant reflux-like symptoms, and in patients with a longer symptom history.
Veldhuyzen van Zanten
S J O
SJ
Division of Gastroenterology, Dalhousie University, Halifax, NS, Canada. zanten@dal.ca
Thomson
A B R
AB
Barkun
A N
AN
Armstrong
D
D
Chiba
N
N
White
R J
RJ
Escobedo
S
S
Sinclair
P
P
D000368:Aged; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D004415:Dyspepsia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence