Gastric surgery is not a risk factor for the development or progression of Barrett's epithelium.
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.
Akiyama
Tomoyuki
T
Gastroenterology Division, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Inamori
Masahiko
M
Akimoto
Keiko
K
Iida
Hiroshi
H
Mawatari
Hironori
H
Endo
Hiroki
H
Nozaki
Yuichi
Y
Yoneda
Kyoko
K
Ikeda
Tamon
T
Sakamoto
Yasunari
Y
Fujita
Koji
K
Yoneda
Masato
M
Takahashi
Hirokazu
H
Goto
Ayumu
A
Hirokawa
Satoru
S
Abe
Yasunobu
Y
Kirikoshi
Hiroyuki
H
Kobayashi
Noritoshi
N
Kubota
Kensuke
K
Saito
Satoru
S
Rino
Yasushi
Y
Nakajima
Atsushi
A
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