THE PREVALENCE OF INTESTINAL METAPLASIA IN PATIENTS WITH AND WITHOUT PEPTIC STRICTURES

Objective: Several studies suggest that patients with esophageal pepti c strictures have a high prevalence of Barrett's esophagus. However, t hese studies did not include appropriate control groups, were retrospe ctive in nature, or did not strictly define Barrett's esophagus. Our a im was to compare the prevalence of Barrett's esophagus in patients wi th and without gastroesophageal reflux disease strictures in a prospec tive study. Methods: Seventy-nine patients referred for endoscopy for gastroesophageal reflux disease symptoms were evaluated. We collected demographic information and an esophageal symptom assessment. Biopsy s pecimens were obtained from peptic strictures, Schatzki rings, or from any areas of columnar-lined esophagus or mucosal injury, Barrett's es ophagus was strictly defined as the presence of intestinal metaplasia from tubular esophagus. Results: There were 46 patients without strict ures and 28 patients with peptic strictures. Five patients had Schatzk i's rings, The prevalence of intestinal metaplasia was 23.9% in patien ts without strictures, and 25% in patients with peptic strictures (p = NS), There was no difference in prevalence of short-or long-segment B arrett's esophagus between the groups, Patients with strictures were o lder than patients without strictures (mean age 58.9 vs 48.6 yr), and more likely to have mucosal injury (50% vs 26.1%), Otherwise, there we re no significant differences with regards to gender, race, heartburn duration or frequency. Conclusions: Barrett's esophagus, as defined by the presence of intestinal metaplasia in the tubular esophagus, is eq ually common in patients with and without peptic strictures. There doe s not appear to be an association between Barrett's esophagus and pept ic strictures. (C) 1998 by Am. Coll. of Gastroenterology.