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 23 November 2017

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News

Barrett's more common in older male colonoscopy patients

Barrett's esophagus and reflux symptoms are more common in male patients over 65 years referred for colonoscopy, however, the reflux symptoms are a poor predictor of Barrett's, finds the latest American Journal of Gastroenterology.

News image

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Barrett's esophagus is the precursor of esophageal adenocarcinoma.

Most patients with esophageal adenocarcinoma present outside of a Barrett's esophagus surveillance program.

This could be due to undiagnosed symptomatic gastroesophageal reflux and Barrett's esophagus in patients without reflux symptoms.

Another cause may be Barrett's esophagus and/or esophageal adenocarcinoma occurring in patients without reflux symptoms.

Dr Eric Ward and his colleagues studied the prevalence of Barrett's esophagus and symptoms in older patients referred for colonoscopy.

All patients for outpatient colonoscopy were eligible if they were at least 65 year old and had not previously undergone esophagoscopy.

After informed consent, the patients completed detailed gastroesophageal reflux questionnaires.

Barrett's esophagus occurred in 22% of male vs 11% in female patients
American Journal of Gastroenterology

During the research endoscopy, the endoscopist recorded the squamocolumnar junction as either long-segment, short-segment Barrett's esophagus or normal.

If the squamocolumnar junction was felt to be "irregular" the endoscopist was asked to predict, in their judgment, if Barrett's esophagus was present.

The research team reported that all patients had biopsies below the squamocolumnar junction.

The biopsies were examined by a gastrointestinal pathologist who was blinded to the endoscopic findings.

The researchers found that Barrett's esophagus was present in 17% of the patients studied.

Barrett's esophagus occurred in 22% of male patients and 11% in female patients.

Gastroesophageal reflux disease symptoms were reported in 35% and Barrett's esophagus was present in 20% of symptomatic and 15% of asymptomatic cases.

The team observed that the majority of the Barrett's esophagus in this study was less than 3 cm in length in 92% of patients.

The questionnaires did not predict the presence of Barrett's esophagus .

Dr Ward's team concluded, “Barrett's esophagus is common in unscreened male and female patients at least 65 year of age who are referred for colonoscopy.”

“Men were more likely than women to have Barrett's esophagus although it occurred in both sexes.”

“Reflux symptoms were fairly common but a poor predictor of Barrett's esophagus.”

Am J Gastroenterol 2006: 101(1): 12
18 January 2006

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