Document Detail


A predictive model for length of Barrett's esophagus with hiatal hernia length and duration of esophageal acid exposure.
MedLine Citation:
PMID:  14528207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A significant correlation between the duration and height of esophageal acid exposure and the length of Barrett's mucosa has been demonstrated. The aims of this study were to determine if there is a correlation between hiatal hernia length and Barrett's esophagus length, and to develop a predictive model for Barrett's esophagus length by using hiatal hernia length and duration of esophageal acid exposure. METHODS: Consecutive patients with Barrett's esophagus diagnosed endoscopically were enrolled in the study. Barrett's esophagus was defined by the presence of intestinal metaplasia in biopsy specimens obtained from salmon-colored mucosa extending into the esophagus. Barrett's mucosa 3 cm or greater in length was considered long-segment Barrett's esophagus; and less than 3 cm long was considered short-segment Barrett's esophagus. Hiatal hernia was considered present if the esophagogastric junction was displaced 1 cm or more proximal to the diaphragmatic hiatus. RESULTS: Twenty-four men (mean age 66.1 +/-2.4 [SE]) with Barrett's esophagus were included in this study. Mean Barrett's length was 4.1 +/-0.7 cm. The Pearson correlation coefficient between hiatal hernia length and Barrett's esophagus length was 0.62 (p < 0.01). Similarly, there was a significant correlation between esophageal acid exposure and Barrett's length (r = 0.62; p < 0.01). Multiple linear regression analysis revealed that hiatal hernia length and duration of esophageal acid exposure were associated significantly with length of Barrett's mucosa (R(2) = 0.54; p < 0.001). A regression equation was developed expressing mean Barrett's length (cm) = 0.79 + (0.68) hernia length (cm) + (0.075) duration of esophageal acid exposure (% time pH < 4). CONCLUSIONS: The length of Barrett's mucosa correlated with the length of hiatal hernia. A predictive model for Barrett's length by using hiatal hernia length and duration of esophageal acid exposure was developed. This suggested that these two pathophysiologic factors are good predictors of the length of Barrett's mucosa.
Authors:
Donald E Wakelin; Tariq Al-Mutawa; Chris Wendel; Colleen Green; Harinder S Garewal; Ronnie Fass
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  58     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-10-06     Completed Date:  2004-01-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-5     Citation Subset:  IM    
Affiliation:
Department of Medicine, Southern Arizona VA Health Care System, University of Arizona Health Sciences Center, Tucson 85723-0001, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Barrett Esophagus / pathology*
Biopsy
Esophagoscopy
Esophagus / pathology
Gastroesophageal Reflux / pathology*
Hernia, Hiatal / pathology*
Humans
Hydrogen-Ion Concentration
Linear Models
Male
Models, Biological
Monitoring, Physiologic
Mucous Membrane / pathology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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