Prevalence of short-segment Barrett's epithelium

Background/aims. The incidence of adenocarcinoma of the oesophagus has incr eased. Its major risk factor is Barrett's epithelium of which the sine qua non is microscopically diagnosed intestinal metaplasia. Short segment Barre tt's epithelium may often be overlooked during routine endoscopy. In routin e biopsies taken from normal-appearing mucosa of the distal oesophagus, the reported rates of short segment Barrett's epithelium in the distal oesopha gus reached 36%. We compared these rates with the results obtained in a com munity hospital in Israel. Methods. Consecutive patients undergoing oesophagogastroduodenoscopy were e nrolled. Biopsy specimens taken from cardia, oesophagogastric junction and 2 cm above the oesophagogastric junction were stained with haematoxylin & e osin and Alcian blue. Results, There were 112 study patients (mean age +/- SD 48.9 +/- 8.3 years, 51.8% males). Nine (8.04%) patients had intestinal metaplasia (according t o specimen from 2 cm above oesophagogastric junction), and symptoms of gast ro-oesophageal reflux were found in only four (44.4% of them. Of these nine patients, six (6.66%) had normal-appearing mucosa and three (3.33%) had ma croscopic Barrett's epithelium. Alcian blue staining revealed two patients with intestinal metaplasia that haematoxylin & eosin staining had missed. Conclusion, We found an 8% prevalence of intestinal metaplasia compared to 18-36% reported in the literature. We also determined that the added advant age of routine biopsy was 5.4%.