title: A cross-sectional analysis of the prevalence of Barrett esophagus in otolaryngology patients with laryngeal symptoms.
abstract: BACKGROUND
  Populations at risk for esophageal adenocarcinoma remain poorly defined. Laryngeal symptoms can be secondary to laryngopharyngeal reflux (LPR) and can occur without associated gastroesophageal reflux symptoms such as heartburn and regurgitation.
  
  
  OBJECTIVE
  We sought to determine the prevalence of Barrett esophagus (BE) in otolaryngology patients with laryngeal symptoms±typical gastroesophageal reflux disease (GERD) symptoms.
  
  
  METHODS
  We performed a cross-sectional study of otolaryngology clinic patients who reported laryngeal symptoms. Symptoms, medications, and exposure histories were obtained. Unsedated transnasal endoscopy was performed. Suspected BE was biopsied and confirmed histologically. Risk factors and prevalence of BE were assessed.
  
  
  RESULTS
  Two hundred ninety-five patients were enrolled [73% male, median age 60 y (interquartile range 51 to 68 y)]. The overall prevalence of BE was 11.8% (n=33). Antisecretory medication use was present in 56% (n=156) of patients at enrollment. Compared with patients without BE, patients with BE were more likely to be male (P=0.01) and to report occupational lung injury (P=0.001). Duration, but not severity of laryngeal symptoms, significantly increased the odds of BE (odds ratio, 5.64; 95% confidence interval, 1.28-24.83; for a duration of symptoms >5 y). Of patients with BE, 58% (n=19) had coexisting LPR and GERD symptoms and 30% (n=10) had only LPR symptoms. Presence and size of hiatal hernia and length of columnar-lined esophagus were significant risk factors for BE.
  
  
  CONCLUSIONS
  Long-standing laryngeal symptoms are associated with the presence of BE in otolaryngology patients. Patients with chronic laryngeal symptoms and no identifiable ear, nose, or throat etiology for those symptoms may benefit from endoscopic screening regardless of whether typical GERD symptoms are present.
authors.affiliation: *Department of Cardiothoracic Surgery, Division of Thoracic and Foregut Surgery, University of Pittsburgh §Department of Surgery, Western Pennsylvania Hospital, West Penn Allegheny Health System, Pittsburgh, PA Departments of †Otolaryngology ‡Surgery ∥Pathology #Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR ¶Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC.
authors.forename: Katie S
authors.initials: KS
authors.lastname: Nason
authors.forename: Thomas
authors.initials: T
authors.lastname: Murphy
authors.forename: Joshua
authors.initials: J
authors.lastname: Schindler
authors.forename: Paul H
authors.initials: PH
authors.lastname: Schipper
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Hoppo
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.forename: David A
authors.initials: DA
authors.lastname: Sauer
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Shaheen
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Morris
authors.forename: Blair A
authors.initials: BA
authors.lastname: Jobe
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000473:pathology; D001706:Biopsy; D003430:Cross-Sectional Studies; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000473:pathology; D006551:Hernia, Hiatal / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors