The prevalence of suspected Barrett's esophagus in children and adolescents: a multicenter endoscopic study.
BACKGROUND
The prevalence of Barrett's esophagus (BE) in young individuals is unclear.


OBJECTIVE
To estimate the prevalence of suspected BE in children and adolescent patients undergoing endoscopy.


METHODS
A retrospective cross-sectional study.


METHODS
Prospectively collected data in the Pediatric Clinical Outcomes Research Initiative (PEDS-CORI).


METHODS
We identified patients younger than 20 years of age with suspected BE in the PEDS-CORI between 1999 and 2002; the corresponding histopathologic records were examined.


METHODS
We analyzed the distribution of demographic and endoscopic risk factors for BE between cases and non-cases with and without suspected BE in bivariate and multivariable analyses.


RESULTS
We identified a total of 6731 patients who underwent upper endoscopy in 12 pediatric facilities. Only 17 patients had suspected BE (prevalence, 2.5 per 1000). Intestinal metaplasia was reported in only 9 of these patients (53%). Patients with suspected BE were older than patients without BE (median 14.7 vs 10.1 years; P = .011). Hiatus hernia was more commonly recorded in patients with suspected BE (11.8% vs 2.2%; P = .008). In a logistic regression model, both older age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.02-1.35) and hiatus hernia (OR 4.62, 95% CI 1.03-20.66) were independently associated with suspected BE.


CONCLUSIONS
Endoscopically suspected BE is rare (<0.25%) in children and adolescents. Older age and the presence of hiatus hernia are possible risk factors for BE in this group.


CONCLUSIONS
Lack of standardization for identifying and recording endoscopic landmarks.
El-Serag
Hashem B
HB
The Michael E. DeBakey Veterans Affairs Medical Center (152), 2002 Holcombe Blvd, Houston, TX 77030, USA. hasheme@bcm.tmc.edu
Gilger
Mark A
MA
Shub
Mitchell D
MD
Richardson
Peter
P
Bancroft
John
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000175:diagnosis / Q000453:epidemiology; D004945:Esophagoscopy; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007417:Intestinal Polyps / Q000175:diagnosis / Q000453:epidemiology; D016015:Logistic Models; D008679:Metaplasia / Q000175:diagnosis / Q000453:epidemiology; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology