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Risk factors for Barrett's esophagus in Indian patients with gastroesophageal reflux disease
Author(s) -
Mathew Praveen,
Joshi Amita S,
Shukla Akash,
Bhatia Shobna J
Publication year - 2011
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06714.x
Subject(s) - medicine , gerd , gastroenterology , odds ratio , intestinal metaplasia , reflux , hernia , hiatal hernia , body mass index , esophagus , risk factor , biopsy , barrett's esophagus , confidence interval , dysplasia , disease , surgery , adenocarcinoma , cancer
Background and Aims: Barrett's esophagus (BE) is reported to be infrequent in Asians, with no data from India regarding its prevalence and risk factors. We investigated the frequency and risk factors of columnar mucosa with or without specialized intestinal metaplasia (SIM) in Indian patients with gastroesophageal reflux disease (GERD). Methods: A total of 278 GERD patients over 2 years underwent gastroscopy and completed a questionnaire for possible BE risk factors. Patients with columnar mucosa on endoscopy underwent four‐quadrant biopsy; BE was histologically defined as columnar mucosa with or without SIM. Patients without columnar mucosa at endoscopy were considered as controls and compared to patients with BE and those with SIM. Results: Forty‐six patients with GERD had columnar mucosa on histology (16.54%); 25 (8.99%) of these had SIM. The risk factors for BE were the presence of hiatus hernia (odds ratio [OR]: 3.14; 95% confidence interval [CI]: 1.2–8.17) and a history of eructation (OR: 2.28; CI: 1.11–4.66). The risk factors for SIM were age ≥ 45 years (OR: 2.63; CI: 1.03–6.71), hiatus hernia (OR: 3.95; CI: 1.24–12.56), and a history of eructation (OR: 3.41; CI: 1.19–9.78). Sex, severity of symptoms, dietary factors, tobacco or alcohol use, and body mass index were not associated with BE. The median circumferential segment length was 2 (1–10) cm, and the maximal length was 3 (2–11) cm in both groups. Conclusion: BE is not an uncommon finding among Indian GERD patients. Age ≥ 45 years, history of eructation, and the presence of hiatus hernia are associated with SIM.