Gastroesophageal reflux symptoms occur with similar frequency in males and females, yet Barrett's esophagus is less common in females.
The reason for this disparity is unknown and the aim of this study was to determine the factors related to Barrett's in females.
Professor DeMeester and colleagues from California, America retrospectively reviewed the records of 796 patients (462 male, 334 female) from 1990 to 2000 for symptoms of reflux.
The research team identified physiologic abnormalities based on results of endoscopic, motility, pH, and Bilitec testing.
Esophageal bilirubin exposure is the only significant factor associated with the presence of Barrett's |
| The American Journal of Gastroenterology |
The researchers determined factors related to the presence of Barrett's using univariate and multivariate analysis.
The team observed that females with reflux symptoms were significantly less likely to have a positive 24-hour pH test, a defective lower esophageal sphincter, or a hiatal hernia than males with reflux symptoms.
In addition, the investigators noted that females with reflux on the basis of an abnormal 24-hour pH test had significantly less esophageal acid exposure than males with reflux.
The investigative team also found that esophageal exposure to refluxed acid and bilirubin was similar in females (n = 50) and males (n = 136) with Barrett's.
On using multivariable analysis, the researchers showed that increased esophageal bilirubin exposure was the only significant factor associated with the presence of Barrett's in male and female patients with reflux disease.
Professor DeMeester concludes, “Females with reflux symptoms have less esophageal acid exposure on average than males, however females and males with Barrett's have a similar severity of reflux.”
“The female gender does not protect against the development of Barrett's in the setting of advanced reflux disease.”
”Esophageal bilirubin exposure is the major risk factor for the presence of Barrett's in patients with reflux disease.”