Background
Barrett's esophagus (BE) in children has been examined in retrospective studies, consisting
of case series and cross-sectional studies.
Objective
To evaluate the prevalence and determinants of BE in children who are free from neurodevelopmental
disorders and tracheoesophageal abnormalities.
Design
A prospective, cross-sectional study.
Setting
Three pediatric GI Centers in Houston, Texas; Phoenix, Arizona; and Portland, Maine
between February 2006 and December 2007.
Patients
This study involved children and adolescents consecutively presenting for elective
upper endoscopy. Patients with neurodevelopmental and tracheoesophageal disorders
were excluded.
Intervention
Endoscopic pictures of all cases with suspected BE were independently reviewed and
verified by two experienced investigators. Esophageal biopsy specimens were obtained
in all patients, and targeted biopsy specimens also were obtained from suspected BE.
Main Outcome Measurements
Endoscopically suspected BE and histologically confirmed BE.
Results
A total of 840 patients (mean age 9.5 years) were enrolled and had complete questionnaire
and endoscopic data. Twelve patients were suspected of having BE (prevalence of 1.43%;
95% confidence interval [CI], 0.73-2.45), and only 1 patient had intestinal metaplasia,
for a prevalence of 0.12% (95% CI, 0-0.65), whereas the rest had gastric oxyntic glands
(n = 6) or squamous esophageal epithelium (n = 5). Patients with suspected BE had
a higher mean body mass index (23.0 vs 19.1, P = .05) and more chest pain (50% vs 13%, P < .01) than patients without BE or reflux esophagitis. There was a trend toward a
higher frequency of dysphagia, heartburn, and regurgitation in patients with suspected
BE.
Limitations
The accuracy of BE prevalence estimates is limited by the small number of cases.
Conclusion
BE is rare in children without neurodevelopmental delay or tracheoesophageal anomalies
presenting for elective upper endoscopy.
Abbreviations:
CI (confidence interval), BE (Barrett's esophagus), PPI (proton pump inhibitor), SD (standard deviation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 28, 2011
Accepted:
January 6,
2011
Received:
July 27,
2010
Footnotes
DISCLOSURE: M. Gilger and H. El-Serag are supported by grants R03 (NIH 1-R03-DK068148-01). H. El-Serag also is supported in part by grants from the Texas Gulf Coast Digestive Diseases Center (NIH P50 DK56338) and the Houston Veterans Affairs HSR&D Center of Excellence (HFP90-020). No other financial relationships relevant to this publication were disclosed.
Identification
Copyright
© 2011 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
