title: Barrett's esophagus in children and adolescents without neurodevelopmental or tracheoesophageal abnormalities: a prospective study.
abstract: BACKGROUND
  Barrett's esophagus (BE) in children has been examined in retrospective studies, consisting of case series and cross-sectional studies.
  
  
  OBJECTIVE
  To evaluate the prevalence and determinants of BE in children who are free from neurodevelopmental disorders and tracheoesophageal abnormalities.
  
  
  METHODS
  A prospective, cross-sectional study.
  
  
  METHODS
  Three pediatric GI Centers in Houston, Texas; Phoenix, Arizona; and Portland, Maine between February 2006 and December 2007.
  
  
  METHODS
  This study involved children and adolescents consecutively presenting for elective upper endoscopy. Patients with neurodevelopmental and tracheoesophageal disorders were excluded.
  
  
  METHODS
  Endoscopic pictures of all cases with suspected BE were independently reviewed and verified by two experienced investigators. Esophageal biopsy specimens were obtained in all patients, and targeted biopsy specimens also were obtained from suspected BE.
  
  
  METHODS
  Endoscopically suspected BE and histologically confirmed BE.
  
  
  RESULTS
  A total of 840 patients (mean age 9.5 years) were enrolled and had complete questionnaire and endoscopic data. Twelve patients were suspected of having BE (prevalence of 1.43%; 95% confidence interval [CI], 0.73-2.45), and only 1 patient had intestinal metaplasia, for a prevalence of 0.12% (95% CI, 0-0.65), whereas the rest had gastric oxyntic glands (n=6) or squamous esophageal epithelium (n=5). Patients with suspected BE had a higher mean body mass index (23.0 vs 19.1, P=.05) and more chest pain (50% vs 13%, P<.01) than patients without BE or reflux esophagitis. There was a trend toward a higher frequency of dysphagia, heartburn, and regurgitation in patients with suspected BE.
  
  
  CONCLUSIONS
  The accuracy of BE prevalence estimates is limited by the small number of cases.
  
  
  CONCLUSIONS
  BE is rare in children without neurodevelopmental delay or tracheoesophageal anomalies presenting for elective upper endoscopy.
authors.affiliation: Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.
authors.forename: Dang M
authors.initials: DM
authors.lastname: Nguyen
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
authors.forename: Mitchell
authors.initials: M
authors.lastname: Shub
authors.forename: Mark
authors.initials: M
authors.lastname: Integlia
authors.forename: Louise
authors.initials: L
authors.lastname: Henderson
authors.forename: Peter
authors.initials: P
authors.lastname: Richardson
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fairly
authors.forename: Mark A
authors.initials: MA
authors.lastname: Gilger
mesh_terms: D000293:Adolescent; D001471:Barrett Esophagus / Q000175:diagnosis / Q000453:epidemiology*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004947:Esophagus / Q000002:abnormalities / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014132:Trachea / Q000002:abnormalities; D014481:United States / Q000453:epidemiology