THE RELATIONSHIP BETWEEN GASTROESOPHAGEAL REFLUX DISEASE AND ITS COMPLICATIONS WITH BARRETTS-ESOPHAGUS

Background: Barrett's esophagus is a condition in which the stratified squamous epithelium of the esophagus is replaced by a columnar epithe lium with malignant potential. Chronic gastroesophageal reflux disease (GERD) is accepted as the primary risk factor for the development of Barrett's esophagus, but only a small fraction of individuals with GER D develop Barrett's esophagus. We sought to identify factors that incr ease the risk of Barrett's esophagus in those with GERD. Objective: Th e objective of this matched case-control study was to investigate poss ible clinical risk factors for Barrett's esophagus. Methods: The study was based on 79 case patients with Barrett's esophagus and 180 contro l patients. Each case patient was matched to one control patient whose indication for endoscopy was GERD and one control patient who underwe nt endoscopy for other indications. The case and control patients were matched for age, gender, and race. All patients underwent endoscopy a t Duke University Medical Center, Durham, NC, between July 1992 and Au gust 1994. Results: On average, patients with Barrett's esophagus deve loped reflux symptoms at an earlier age than age- and gender-matched c ontrol patients and also had a longer duration of symptoms. Complicati ons of reflux, including esophagitis, stricture, and ulceration, were reported significantly more frequently in the group of case patients t han either group of control patients. Conclusions: The results of this pilot study indicate that age of onset, duration of symptoms, and com plications of GERD may be markers of increased risk of Barrett's esoph agus.