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Background and Aims: Barrett's esophagus (BE) is reported to be infrequent in Asians, with no data from India regarding the prevalence and risk factors for BE. We investigated the frequency and risk factors of columnar mucosa with or without specialized intestinal metaplasia (SIM) in Indian patients with gastro-esophageal reflux disease (GERD). Methods: Two hundred and seventy-eight GERD patients over two years underwent gastroscopy and a questionnaire for possible risk factors for BE. 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. Risk factors for BE were presence of hiatus hernia (OR 3.14 [95% CI [1.2-8.17]) and history of eructation (OR 2.28 [1.11-4.66]). Risk factors for SIM were age ≥45 years (OR 2.63 [1.03 -6.71]), hiatus hernia (OR 3.95 [1.24 - 12.56]) and history of eructation (OR 3.41 [1.19 - 9.78]). Gender, severity of symptoms, dietary factors, tobacco or alcohol use, and BMI were not associated with BE. Median circumferential segment length was 2 (1 -10) cms and maximal length was 3 (2 - 11) cms in both groups. Conclusions: BE is not an uncommon finding among Indian GERD patients. Age ≥45 years, history of eructation, presence of hiatus hernia are associated with SIM.
Department of Gastroenterology, and Department of Pathology, Seth G S Medical college & King Edward Memorial Hospital, Mumbai 400 012, India.
This article was published in the following journal.
Name: Journal of gastroenterology and hepatology
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A condition with damage to the lining of the lower ESOPHAGUS resulting from chronic acid reflux (ESOPHAGITIS, REFLUX). Through the process of metaplasia, the squamous cells are replaced by a columnar epithelium with cells resembling those of the INTESTINE or the salmon-pink mucosa of the STOMACH. Barrett's columnar epithelium is a marker for severe reflux and precursor to ADENOCARCINOMA of the esophagus.
The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.
A motility disorder of the ESOPHAGUS in which the LOWER ESOPHAGEAL SPHINCTER (near the CARDIA) fails to relax resulting in functional obstruction of the esophagus, and DYSPHAGIA. Achalasia is characterized by a grossly contorted and dilated esophagus (megaesophagus).
Reduction of high-risk choices and adoption of low-risk quantity and frequency alternatives.
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