Document Detail

Barrett's esophagus in females: a comparative analysis of risk factors in females and males.
MedLine Citation:
PMID:  15743352     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Gastroesophageal reflux symptoms occur with similar frequency in males and females, yet Barrett's esophagus is less common in females. The reason for this disparity is unknown. The aim of this study was to determine the factors related to Barrett's in females. METHODS: The records of 796 patients (462 male, 334 female) evaluated from 1990 to 2000 for symptoms of reflux were retrospectively reviewed. Physiologic abnormalities based on results of endoscopic, motility, pH, and Bilitec testing were identified, and factors related to the presence of Barrett's were determined using univariate and multivariate analysis. RESULTS: Females with reflux symptoms were significantly less likely to have a positive 24-h pH test, a defective lower esophageal sphincter, or a hiatal hernia than males with reflux symptoms. Further, females with reflux on the basis of an abnormal 24-h pH test had significantly less esophageal acid exposure than males with reflux. In contrast, esophageal exposure to refluxed acid and bilirubin was similar in females (n = 50) and males (n = 136) with Barrett's. On multivariable analysis increased esophageal bilirubin exposure was the only significant factor associated with the presence of Barrett's in male and female patients with reflux disease. CONCLUSIONS: Females with reflux symptoms have less esophageal acid exposure on average than males. However, females and males with Barrett's have a similar severity of reflux, and the female gender does not protect against the development of Barrett's in the setting of advanced reflux disease. Esophageal bilirubin exposure is the major risk factor for the presence of Barrett's in patients with reflux disease.
Farzaneh Banki; Steven R Demeester; Rodney J Mason; Guilherme Campos; Jeffrey A Hagen; Jeffrey H Peters; Cedric G Bremner; Tom R Demeester
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  100     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-03     Completed Date:  2005-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  560-7     Citation Subset:  IM    
Department of Surgery and Cardiothoracic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, California, USA.
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MeSH Terms
Barrett Esophagus / etiology*
Bilirubin / physiology
Gastroesophageal Reflux / etiology
Hydrogen-Ion Concentration
Middle Aged
Retrospective Studies
Risk Factors
Sex Factors
Reg. No./Substance:

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