In a case comparison study published in the November issue of the journal Archives of Surgery, 502 consecutive patients with gastroesophageal reflux disease (GERD) were documented by 24-hour esophageal pH monitoring.
A complete demographic, endoscopic, and physiologic evaluation was also conducted on each patient to allow the study population to be divided into two groups, according to the presence and extent of Barrett's esophagus (BE).
Within the study population, 174 cases of BE were identified.
Of these, 67 patients had short-segment BE, and 107 were diagnosed with long-segment BE.
The clinical, endoscopic, and physiologic data collected on each patient was then studied by multivariate analysis, to identify any independent predictors of the presence and extent of BE.
The research team, from the Department of Surgery, at the Keck School of Medicine, University of Southern California, Los Angeles, USA, found 7 factors to be predictors of BE.
|BE in patients with GERD - 7 different predictive factors identified.
| Archives of Surgery |
The first of these, abnormal bile reflux, was the only one identified as a predictor of short-segment BE (baseline, no BE).
In comparison, 3 factors were noted as being predictors of long-segment BE (baseline, short-segment BE). These were a hiatal hernia larger than 4 cm, a defective lower esophageal sphincter, and an abnormal number of reflux episodes lasting longer than 5 minutes.
The remaining factors identified as being independent predictors of BE were male sex, defective distal esophageal contraction, and GERD symptoms lasting for more than 5 years.
Dr Guilherme M R Campos, one of the members of the groups that carried out the research, commented that their findings showed that among patients with GERD, specific factors are associated with the presence and extent of BE.
He added, "Elimination of reflux with an antireflux operation in patients with one or more of these factors may prevent the future development of BE."