Clinical Question:
How common is Barrett's esophagus, and what is the relationship between
reflux symptoms and Barrett's esophagus?
Bottom Line:
Barrett's Esophagus was found in 1.6% of the general Swedish population.
Alcohol and smoking were significant risk factors.
Reference:
Ronkainen J, Aro P, Storskrubb T, et al. Prevalence of Barrett's esophagus
in the general population: an endoscopic study. Gastroenterology
2005;129:1825-831.
Study Design:
Cross-sectional
Synopsis:
Barrett's esophagus (BE) is associated with esophageal adenocarcinoma, the
incidence of which has been increasing dramatically. The prevalence of BE in
the general population is uncertain because upper endoscopy is required for
diagnosis. This study aimed to determine the prevalence of BE and possible
associated risk factors in an adult Swedish population. A random sample (n =
3000) of the adult population (n = 21,610) in 2 municipalities was surveyed
using a validated gastrointestinal symptom questionnaire (response rate,
74%); a random subsample (n = 1000; mean age, 53.5 years; 51% female)
underwent upper endoscopy. Endoscopic signs suggestive of columnar-lined
esophagus (CLE) were defined as mucosal tongues or an upward shift of the
squamocolumnar junction. BE was diagnosed when specialized intestinal
metaplasia was detected histologically in suspected CLE. BE was present in
16 subjects (1.6%; 95% confidence interval, 0.8-2.4): 5 with a long segment
and 11 with a short segment. Overall, 40% reported reflux symptoms and 15.5%
showed esophagitis; 103 (10%) had suspected CLE, and 12 (1.2%) had a visible
segment > or = 2 cm. The prevalence of BE in those with reflux symptoms was
2.3% and in those without reflux symptoms was 1.2% (P = .18). In those with
esophagitis, the prevalence was 2.6%; in those without, the prevalence was
1.4% (P = .32). Alcohol (P = .04) and smoking (P = .047) were independent
risk factors for BE. |