Association between symptomatic gastroesophageal reflux and Barrett's esophagus

Background: Barrett esophagus is a proximal displacement of the squamocolumnar junction relative to the gastroesophageal junction with intestinal metaplasia, it has been linked to gastroesophageal reflux disease. However, it has been observed in individuals without gastroesophageal reflux symptoms, with prevalence up to 25% in 50 years older men.

Objective: Assess the association between symptomatic gastroesophageal reflux and Barrett's esophagus.

Methods: Consecutive patients undergoing endoscopy at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire for determining 2 groups (patients with and without gastroesophageal reflux symptoms). Those subjects with suggestive image of Barrett's esophagus, biopsy specimens were obtained from the distal esophageal mucosa with the intention of find intestinal metaplasia. We compared prevalence of Barrett's esophagus between groups.

Results: One hundred and nine patients were studied. Prevalence of symptomatic gastroesophageal reflux disease was 37.6%. Barrett's esophagus was found in 9.7% of symptomatic gastroesophageal reflux disease patients and in 9.6% of subjects without symptoms of gastroesophageal reflux disease (p = 0.87). Gender and age were similar between groups. Prevalence of hernia hiatal was bigger in patients with Barrett's esophagus (90 vs. 42%) (p = 0.004).

Conclusions: Our study didn't show association between symptomatic gastroesophageal reflux detected by a questionnaire and Barrett's esophagus.