title: Gastroesophageal reflux and related pathology in adults who were born with esophageal atresia: a long-term follow-up study.
abstract: OBJECTIVE
  Esophageal atresia (EA) is the most common congenital anomaly of the esophagus. There are few long-term follow-up data on adults who had surgery for EA as infants. The primary aims were to evaluate the prevalence of esophageal symptoms and pathology and second to develop recommendations for follow-up.
  
  
  METHODS
  This is a descriptive study of individuals attending a clinic in an adult tertiary referral hospital, established to provide care for adults who had surgery for EA as infants. Individuals aged 20 years or older were identified from an existing database and invited by telephone to attend the clinic. One hundred thirty-two patients attended the clinic from 2000-2003. Individuals were assessed by using a structured questionnaire. Endoscopy was performed in 62 patients because of symptoms.
  
  
  RESULTS
  Reflux symptoms were reported by 83 (63%), including 25 (19%) with severe symptoms. Dysphagia was reported by 68 patients (52%). Of those who underwent endoscopy, reflux esophagitis was present in 36 patients (58%), Barrett's esophagus in 7 (11%), and strictures in 26 (42%) patients. One patient was diagnosed with esophageal squamous cell carcinoma. Men who were 35 years or older and individuals with severe reflux symptoms were at high risk of having severe esophagitis or Barrett's metaplasia.
  
  
  CONCLUSIONS
  Reflux symptoms, esophagitis, and Barrett's esophagus are common in these individuals. We recommend clinical assessment as adults and upper endoscopy for reflux symptoms or dysphagia. Transition of young adults from pediatric care to an adult gastroenterology clinic with expertise in EA appears to be highly beneficial.
authors.affiliation: Gastroenterology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. taylorac@svhm.org.au
authors.forename: Andrew C F
authors.initials: AC
authors.lastname: Taylor
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Breen
authors.forename: Alex
authors.initials: A
authors.lastname: Auldist
authors.forename: Anthony
authors.initials: A
authors.lastname: Catto-Smith
authors.forename: Tom
authors.initials: T
authors.lastname: Clarnette
authors.forename: Joe
authors.initials: J
authors.lastname: Crameri
authors.forename: Russell
authors.initials: R
authors.lastname: Taylor
authors.forename: Satish
authors.initials: S
authors.lastname: Nagarajah
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Brady
authors.forename: Keith
authors.initials: K
authors.lastname: Stokes
mesh_terms: D000328:Adult; D001471:Barrett Esophagus / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D004933:Esophageal Atresia / Q000453:epidemiology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000453:epidemiology; D004940:Esophageal Stenosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors