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Association of Barrett's Esophagus and Colon Adenomas

16

Shah, Deepa K., M.D.; Gerkin, Richard, M.D.; Ramirez, Francisco C., M.D.; Young, Michele A., M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S28
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Internal Medicine, Banner Good Samaritan, Phoenix, AZ and Gastroenterology, Carl Hayden VA Medical Center, Phoenix, AZ.

Purpose: Barrett's esophagus and colonic ademomas share similar genetic alterations and environmental risk factors. A similar dysplasia to carcinoma sequence is seen in both premalignant conditions, thus the aim is to determine whether Barrett's esophagus is associated with adenomatous lesions in the colon.

Methods: A review of the endoscopic database at a VA medical center was performed from January 1997 to April 2005. The first two hundred patientsts that were men with Barrett's esophagus on upper endoscopy and histological confirmation and had a complete colonoscopy with an adequate prep were included. Two hundred patients with symptoms of reflux and no evidence of Barrett's esophagus or erosive esophagitis meeting the same criteria comprised the control group. The number, size and histology of each polyp was recorded. Advanced neoplasia was defined as one or a combination of adenoma ≥10 mm, villous component, HGD, or invasive carcinoma. Chi square was used to compare proportional data whereas, the student's t-test was used to compare means.

Results: There were 200 patients with Barrett's esophagus, mean age 60.8 ± 0.6 and 200 controls, mean age 59.8 ± 0.8. The BMI's of the Barrett's esophagus and control group were 28.7 ± 0.4 and 29.3 ± 0.4, respectively. 61% of the patients had short segment Barrett's esophagus and 39% had long segment. Characteristics of adenomatous lesions in Barrett's patients and controls are shown below.

Of the patients with advanced neoplasms, 11 had HGD or invasive carcinoma; of these, 45% were Barrett's esophagus patients and 27% were in the control group.

Conclusions:

  1. Adenomatous polyps were found significantly more often in patients with Barrett's esophagus than in patients with symptoms of reflux without Barrett's esophagus.
  2. There was a trend toward more adenomas per patient in the Barrett's esophagus patients than in the controls.
  3. There was a trend toward a greater number of advanced neoplasms in the Barrett's esophagus group compared with the controls.
Table. Ade

Table. Ade

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