Researchers from New Mexico and Illinois, USA, assessed the risk for Barrett's esophagus after partial gastrectomy.
The data of outpatients from a medicine and gastroenterology clinic, who underwent upper gastrointestinal endoscopy for any reason, were analyzed in a case-control study.
A case population of 650 patients with short-segment and 366 patients with long-segment Barrett's esophagus was included in the study. This was compared to a control population of 3047 subjects without Barrett's esophagus or other types of gastroesophageal reflux disease.
In the case population, 25 (4%) patients with short-segment and 15 (4%) patients with long-segment Barrett's esophagus presented with a history of gastric surgery. This was compared with 162 (5%) patients in the control population, yielding an adjusted odds ratio of 0.89 for short-segment and 0.71 for long-segment Barrett's esophagus.
Similar results were obtained in separate analyses of 64 patients with Billroth-1 gastrectomy, 105 patients with Billroth-2 gastrectomy, and 33 patients with vagotomy and pyloroplasty for both short- and long-segment Barrett's esophagus.
| Bile reflux without acid is not sufficient to damage the esophageal mucosa.
| Gastroenterology |
It was found that Caucasian ethnicity, the presence of hiatus hernia, and alcohol consumption were all associated with elevated risks for Barrett's esophagus.
Benjamin Avidan, of the Department of Veterans Affairs Medical Center, Albuquerque, New Mexico, commented on behalf of his team, "Gastric surgery for benign peptic ulcer disease is not a risk factor for either short- or long-segment Barrett's esophagus."
"This lack of association between gastric surgery and Barrett's esophagus suggests that reflux of bile without acid is not sufficient to damage the esophageal mucosa," it was concluded.