BACKGROUND: The prevalence of Barrett's esophagus (BE) in young individuals is unclear. OBJECTIVE: To estimate the prevalence of suspected BE in children and adolescent patients undergoing endoscopy. DESIGN: A retrospective cross-sectional study. SETTING: Prospectively collected data in the Pediatric Clinical Outcomes Research Initiative (PEDS-CORI). PATIENTS: We identified patients younger than 20 years of age with suspected BE in the PEDS-CORI between 1999 and 2002; the corresponding histopathologic records were examined. MAIN OUTCOME MEASUREMENTS: We analyzed the distribution of demographic and endoscopic risk factors for BE between cases and non-cases with and without suspected BE in bivariate and multivariable analyses. RESULTS: We identified a total of 6731 patients who underwent upper endoscopy in 12 pediatric facilities. Only 17 patients had suspected BE (prevalence, 2.5 per 1000). Intestinal metaplasia was reported in only 9 of these patients (53%). Patients with suspected BE were older than patients without BE (median 14.7 vs 10.1 years; P = .011). Hiatus hernia was more commonly recorded in patients with suspected BE (11.8% vs 2.2%; P = .008). In a logistic regression model, both older age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.02-1.35) and hiatus hernia (OR 4.62, 95% CI 1.03-20.66) were independently associated with suspected BE. CONCLUSIONS: Endoscopically suspected BE is rare (<0.25%) in children and adolescents. Older age and the presence of hiatus hernia are possible risk factors for BE in this group. LIMITATIONS: Lack of standardization for identifying and recording endoscopic landmarks.
BACKGROUND: The prevalence of Barrett's esophagus (BE) in young individuals is unclear. OBJECTIVE: To estimate the prevalence of suspected BE in children and adolescent patients undergoing endoscopy. DESIGN: A retrospective cross-sectional study. SETTING: Prospectively collected data in the Pediatric Clinical Outcomes Research Initiative (PEDS-CORI). PATIENTS: We identified patients younger than 20 years of age with suspected BE in the PEDS-CORI between 1999 and 2002; the corresponding histopathologic records were examined. MAIN OUTCOME MEASUREMENTS: We analyzed the distribution of demographic and endoscopic risk factors for BE between cases and non-cases with and without suspected BE in bivariate and multivariable analyses. RESULTS: We identified a total of 6731 patients who underwent upper endoscopy in 12 pediatric facilities. Only 17 patients had suspected BE (prevalence, 2.5 per 1000). Intestinal metaplasia was reported in only 9 of these patients (53%). Patients with suspected BE were older than patients without BE (median 14.7 vs 10.1 years; P = .011). Hiatus hernia was more commonly recorded in patients with suspected BE (11.8% vs 2.2%; P = .008). In a logistic regression model, both older age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.02-1.35) and hiatus hernia (OR 4.62, 95% CI 1.03-20.66) were independently associated with suspected BE. CONCLUSIONS: Endoscopically suspected BE is rare (<0.25%) in children and adolescents. Older age and the presence of hiatus hernia are possible risk factors for BE in this group. LIMITATIONS: Lack of standardization for identifying and recording endoscopic landmarks.
Authors: Dang M Nguyen; Hashem B El-Serag; Mitchell Shub; Mark Integlia; Louise Henderson; Peter Richardson; Kenneth Fairly; Mark A Gilger Journal: Gastrointest Endosc Date: 2011-02-26 Impact factor: 9.427