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Gastroesophageal reflux disease and mucosal injury with emphasis on short-segment Barrett's esophagus and duodenogastroesophageal reflux.

Abstract

Gastroeosphageal reflux disease has been associated with long segments of Barrett's esophagus </=3 cm), but little is known about its association with shorter segments. The aim of this study was to evaluate anatomic and physiologic alterations of the cardia and esophageal exposure to gastric and duodenal juice in patients with short and long segments of Barrett's esophagus. Furthermore, these patients were compared to each other and to patients with erosive esophagitis and those with no mucosal injury. Two hundred sixty-two consecutive patients with foregut symptoms were divided into the following four groups based on endoscopic and histologic findings: group 1, no mucosal injury; group 2, erosive esophagitis; group 3, short-segment Barrett's esophagus; and group 4, long-segment Barrett's esophagus. Esophageal exposure time to acid and bilirubin, lower esophageal sphincter characteristics, and endoscopic anatomy of the cardia were compared between the groups. Patients with short-segment Barrett's esophagus had elevated esophageal acid and bilirubin exposure, decreased lower esophageal sphincter pressure and length, and a high incidence of hiatal hernia. These abnormalities were similar to those in patients with esophagitis and in general less profound than those found in patients with long-segment Barrett's esophagus. The length of intestinal metaplasia was higher in patients with a defective lower esophageal sphincter. Short-segment Barrett's esophagus is a complication of severe gastroesophageal reflux disease and is associated with the reflux of both gastric and duodenal juice similar to that seen in patients with long-segment Barrett's esophagus.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033-4612, USA.

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    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Barrett Esophagus
    Bilirubin
    Cardia
    Chi-Square Distribution
    Esophagitis
    Esophagogastric Junction
    Esophagoscopy
    Female
    Gastroesophageal Reflux
    Humans
    Hydrogen-Ion Concentration
    Intestines
    Male
    Manometry
    Metaplasia
    Middle Aged
    Statistics, Nonparametric

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    10457313

    Citation

    Oberg, S, et al. "Gastroesophageal Reflux Disease and Mucosal Injury With Emphasis On Short-segment Barrett's Esophagus and Duodenogastroesophageal Reflux." Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 2, no. 6, 1998, pp. 547-53; discussion 553-4.
    Oberg S, Ritter MP, Crookes PF, et al. Gastroesophageal reflux disease and mucosal injury with emphasis on short-segment Barrett's esophagus and duodenogastroesophageal reflux. J Gastrointest Surg. 1998;2(6):547-53; discussion 553-4.
    Oberg, S., Ritter, M. P., Crookes, P. F., Fein, M., Mason, R. J., Gadensytätter, M., ... DeMeester, T. R. (1998). Gastroesophageal reflux disease and mucosal injury with emphasis on short-segment Barrett's esophagus and duodenogastroesophageal reflux. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 2(6), pp. 547-53; discussion 553-4.
    Oberg S, et al. Gastroesophageal Reflux Disease and Mucosal Injury With Emphasis On Short-segment Barrett's Esophagus and Duodenogastroesophageal Reflux. J Gastrointest Surg. 1998;2(6):547-53; discussion 553-4. PubMed PMID: 10457313.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gastroesophageal reflux disease and mucosal injury with emphasis on short-segment Barrett's esophagus and duodenogastroesophageal reflux. AU - Oberg,S, AU - Ritter,M P, AU - Crookes,P F, AU - Fein,M, AU - Mason,R J, AU - Gadensytätter,M, AU - Brenner,C G, AU - Peters,J H, AU - DeMeester,T R, PY - 1999/8/24/pubmed PY - 1999/8/24/medline PY - 1999/8/24/entrez SP - 547-53; discussion 553-4 JF - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract JO - J. Gastrointest. Surg. VL - 2 IS - 6 N2 - Gastroeosphageal reflux disease has been associated with long segments of Barrett's esophagus </=3 cm), but little is known about its association with shorter segments. The aim of this study was to evaluate anatomic and physiologic alterations of the cardia and esophageal exposure to gastric and duodenal juice in patients with short and long segments of Barrett's esophagus. Furthermore, these patients were compared to each other and to patients with erosive esophagitis and those with no mucosal injury. Two hundred sixty-two consecutive patients with foregut symptoms were divided into the following four groups based on endoscopic and histologic findings: group 1, no mucosal injury; group 2, erosive esophagitis; group 3, short-segment Barrett's esophagus; and group 4, long-segment Barrett's esophagus. Esophageal exposure time to acid and bilirubin, lower esophageal sphincter characteristics, and endoscopic anatomy of the cardia were compared between the groups. Patients with short-segment Barrett's esophagus had elevated esophageal acid and bilirubin exposure, decreased lower esophageal sphincter pressure and length, and a high incidence of hiatal hernia. These abnormalities were similar to those in patients with esophagitis and in general less profound than those found in patients with long-segment Barrett's esophagus. The length of intestinal metaplasia was higher in patients with a defective lower esophageal sphincter. Short-segment Barrett's esophagus is a complication of severe gastroesophageal reflux disease and is associated with the reflux of both gastric and duodenal juice similar to that seen in patients with long-segment Barrett's esophagus. SN - 1091-255X UR - https://www.unboundmedicine.com/medline/citation/10457313/Gastroesophageal_reflux_disease_and_mucosal_injury_with_emphasis_on_short_segment_Barrett's_esophagus_and_duodenogastroesophageal_reflux_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1091255X98800553 DB - PRIME DP - Unbound Medicine ER -