Prevalence of Barrett's esophagus in patients with moderate to severe erosive esophagitis.
OBJECTIVE
To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation.


METHODS
Patients with EE of Los Angeles (LA) class B, C and D who underwent follow-up endoscopy documenting complete mucosal healing.


RESULTS
A total of 86/169 patients were suspected of having BE (38 before healing and 48 after healing of EE) and, 46/86 eventually had the histological confirmation. At index esophago-gastro-duodenoscopy (EGD), BE was suspected in 38/169 (22%), and ultimately, histologically confirmed in 20 of these. In 11 patients where biopsies were performed in the presence of inflammation, BE was detected in 2 and missed in 5 (including 2 dysplasias). In 131/169 patients (77.5%), BE was not suspected at index EGD. After healing of EE though, 48 patients had suspicion of BE who underwent biopsies, and in 26 of these histology was positive for BE. The length of inflammation had a linear correlation with the length of BE (P = 0.01). Out of multiple variables to predict BE, only the suspicion at index endoscopy was statistically significant (P = 0.01).


CONCLUSIONS
BE was seen in 46/169 (27%) patients with EE of LA class B, C and D. The length of EE can predict the length of underlying BE segment. Even when suspected, BE and associated dysplasia can be missed in the presence of inflammation; therefore, repeat evaluation should be considered after complete healing of esophagitis.
Department of Gastroenterology (111G), Carl. T. Hayden VAMC, 650 E Indian School Road, Phoenix, Arizona 85012, United States. ngilani@pol.net
Nooman
N
Gilani
Richard-D
RD
Gerkin
Francisco-C
FC
Ramirez
Shahina
S
Hakim
Adam-C
AC
Randolph
D001471:Barrett Esophagus / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D001706:Biopsy; D004724:Endoscopy; D004941:Esophagitis / Q000150:complications*; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index