Prevalence and risk factors for Barrett’s esophagus in patients with chronic gastroesophageal reflux disease

Abstract

Introduction/Objective The most important complication of gastroesophageal reflux disease (GERD) is Barrett’s esophagus (BE) and the development of esophageal adenocarcinoma. Prevalence of BE is 5–15% in patients with GERD symptoms. The aim of the study was to investigate the prevalence and risk factors for BE in patients with chronic reflux symptoms. A prospective study was conducted in the Clinic of Gastroenterology, Niš Clinical Center.

Methods We included 676 patients with chronic reflux symptoms, who underwent esophagogastroduodenoscopy. The biopsy specimens were obtained in a four-quadrant fashion at intervals of 2 cm from the circumferential endoscopic Barrett’s epithelium in the distal esophagus. BE was diagnosed by pathological examination.

Results Out of the total number patients with GERD, 92 were diagnosed with columnar-lined esophagus (CLE), the prevalence being 13.6%. Histological examination of biopsy from 92 patients with CLE revealed specialized intestinal metaplasia in 15 patients, with the prevalence of 2.22%. Compared to patients without BE, patients with BE were older and more commonly male. Univariable analyses showed that hiatal hernia and Helicobacter pylori infection were two significant risk factors for the onset of esophagitis. The age and the presence of reflux symptoms were associated with the presence of BE. Older age could be considered a significant risk factor for the development of BE and GERD.

Conclusion Prevalence of biopsy-proven BE and CLE in Serbia was 2.22% and 13.6%, respectively, in patients with GERD symptoms.

Keywords: Barrett’s esophagus; gastroesophageal reflux disease; chronic reflux symptoms