title: Gastric surgery is not a risk factor for the development or progression of Barrett's epithelium.
abstract: OBJECTIVE
  Barrett's epithelium is currently believed to be related to acid gastroesophageal reflux. The aim was to determine the role of pancreatic-biliary reflux in the genesis of Barrett's epithelium.
  
  
  METHODS
  The study population comprised 1055 cases (606 men and 449 women; median age, 67 years) who had undergone an upper endoscopy at the Gastroenterology Division of Yokohama City University Hospital between August 2005 and July 2006. The study population was composed of 869 cases with intact stomachs and 186 cases with distal-gastrectomies. The presence and the progression of Barrett's epithelium were diagnosed based on the Prague C & M Criteria. The correlations of clinical factors, including distal-gastrectomy, with the presence and the progression of Barrett's epithelium were examined.
  
  
  RESULTS
  The study demonstrated that 42.2% of the total population was diagnosed to have Barrett's epithelium and, in 12.6% of the cases with Barrett's epithelium, the progression of Barrett's epithelium was observed during the median 72 month followup. A distal gastrectomy was not significantly correlated with either the incidence or progression of Barrett's epithelium.
  
  
  CONCLUSIONS
  This lack of association between gastric surgery and Barrett's epithelium suggests that pancreatic-biliary reflux with limited acid is not sufficient for the genesis of Barrett's epithelium.
authors.affiliation: Gastroenterology Division, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akiyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Keiko
authors.initials: K
authors.lastname: Akimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Hironori
authors.initials: H
authors.lastname: Mawatari
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nozaki
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yoneda
authors.forename: Tamon
authors.initials: T
authors.lastname: Ikeda
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Ayumu
authors.initials: A
authors.lastname: Goto
authors.forename: Satoru
authors.initials: S
authors.lastname: Hirokawa
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kirikoshi
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Satoru
authors.initials: S
authors.lastname: Saito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors