Tongue-like Barrett's esophagus is associated with gastroesophageal reflux disease.
OBJECTIVE
To test this hypothesis of barrett esophagus (BE) classified into two types and to further determine if there was any correlation between the shape of endoscopically suspected esophageal metaplasia (ESEM), prevalence of reflux esophagitis (RE) and heartburn.


METHODS
A total of 6504 Japanese who underwent endoscopy for their annual stomach check-up were enrolled in this study. BE was detected without histological confirmation that is ESEM. We originally classified cases of ESEM into 3 types based on its shape: Tongue-like (T type), Dome-like (D type) and Wave-like (W type) ESEM. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a one-month period.


RESULTS
ESEM was observed in 10.3% of 6504 subjects (ESEM < 1 cm, 9.4%; 1 cm < or = ESEM < 3 cm, 1.7%; ESEM > or = 3 cm, 0.5%). The frequency of ESEM was significantly higher in males compared with female subjects. Statistical analysis showed that the prevalence of heartburn and RE were significantly higher in the T type ESEM than in the W type ESEM (P < 0.05).


CONCLUSIONS
The T type ESEM was strongly asso-ciated with reflux symptoms and RE whereas the W type ESEM was not associated with GERD.
Yamagishi
Hatsushi
H
Division of Gastroenterology, Tohoku University graduate school of medicine, 1-1 Seiryou-Machi, Aobaku, Sendai 980-8574, Japan. hatsushi@f2.dion.ne.jp
Koike
Tomoyuki
T
Ohara
Shuichi
S
Kobayashi
Shigeyuki
S
Ariizumi
Ken
K
Abe
Yasuhiko
Y
Iijima
Katsunori
K
Imatani
Akira
A
Inomata
Yoshifumi
Y
Kato
Katsuaki
K
Shibuya
Daisuke
D
Aida
Shigemitsu
S
Shimosegawa
Tooru
T
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged