Prevalence of Barrett's esophagus remains low in the Korean population: nationwide cross-sectional prospective multicenter study.
OBJECTIVE
In contrast to the Western population, the prevalence of Barrett's esophagus (BE) is rare in the Korean population. However, the recent increase in prevalence of gastroesophageal reflux disease (GERD) may affect the prevalence of BE. The aim of this study was to survey the prevalence of BE and evaluate its risk factors.


METHODS
Patients between 18 and 75 years of age who visited 11 Korean tertiary referral centers between April and July 2006 for routine upper endoscopic examination were surveyed using a symptom questionnaire. Biopsies were performed on the columnar lined epithelium (CLE) of the distal esophagus, and diagnosis was confirmed with detection of specialized intestinal metaplasia.


RESULTS
The study comprised 2,048 patients (mean age 51.4 years, 965 males). The frequency of heartburn or acid regurgitation was 8.7% and 13.1%, respectively. Reflux esophagitis was diagnosed in 10.1% of patients (207 patients); however, most patients had mild reflux. CLE was found in 82 patients; however, only one patient had long-segment CLE. The prevalence of BE was 1% (21 patients). The risk factors for BE were age (P = 0.006), presence of heartburn [odds ratio (OR) 4.33, 95% confidence interval (CI) 1.66-11.34, P = 0.007], acid regurgitation (OR 3.37, 95% CI 1.35-8.42, P = 0.01), sliding hernia (OR 6.21, 95% CI 1.78-21.72, P = 0.001), and reflux esophagitis (OR 10.28, 95% CI 4.31-24.50, P < 0.0001) on univariate analysis. On multivariate analysis, presence of typical reflux symptoms (P = 0.02) and reflux esophagitis (P < 0.001) were significant.


CONCLUSIONS
Prevalence of Barrett's esophagus remains low in Koreans; however, risk of developing BE has increased in patients with GERD symptoms and reflux esophagitis.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. isle@catholic.ac.kr
In Seok
IS
Lee
Suck Chei
SC
Choi
Ki Nam
KN
Shim
Sam Ryong
SR
Jee
Kyu Chan
KC
Huh
Jun Haeng
JH
Lee
Kwang Jae
KJ
Lee
Hyung Seok
HS
Park
Yong Chan
YC
Lee
Hoon Yong
HY
Jung
Hyo Jin
HJ
Park
D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D001707:Biopsy, Needle; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004945:Esophagoscopy / Q000379:methods; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult