Barrett's esophagus in Japanese patients: its prevalence, form, and elongation.
BACKGROUND
Barrett's esophagus is a well-known acquired condition resulting from gastroesophageal reflux disease (GERD). However, it is still unknown whether Barrett's esophagus develops gradually over time in patients with GERD. To address this issue, we investigated the change in the prevalence and length of short-segment Barrett's esophagus (SSBE) over time.


METHODS
From January 2005 to March 2007, we enrolled 5338 patients who received upper gastrointestinal endoscopy. Prevalence and length of endoscopically identified SSBE were evaluated within groups divided on the basis of 10-year age intervals. The factors possibly influencing SSBE length such as symptoms, antacid use, and endoscopic findings were also evaluated. Additionally, the length change in 236 patients with histologically confirmed Barrett's esophagus was evaluated over a 2-year follow-up.


RESULTS
Of the 5338 enrolled patients, 1997 had SSBE. The prevalence of endoscopically identified SSBE was significantly higher and its length was significantly longer in elderly patients. Multiple regression analysis showed that age, presence of reflux esophagitis, reflux symptoms, and hiatal hernia were positively correlated with SSBE length. Analysis of the 2-year follow-up study of histologically confirmed SSBE revealed significant extension of Barrett's length in 28.0% of 236 patients. Presence of reflux symptoms and hiatal hernia were identified as positive predictors and proton pump inhibitor administration as a negative predictor of SSBE elongation.


CONCLUSIONS
Positive predictors for the extension of SSBE were presence of hiatal hernia and reflux symptoms, but not age.
Okita
Koichi
K
Department of Gastroenterology, Shimane University, School of Medicine, Izumo, Japan.
Amano
Yuji
Y
Takahashi
Yoshiko
Y
Mishima
Yuko
Y
Moriyama
Nobuyuki
N
Ishimura
Norihisa
N
Ishihara
Shunji
S
Kinoshita
Yoshikazu
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D054328:Proton Pump Inhibitors