Endoscopic impression of Barrett esophagus: Declining positive predictive value

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Post on 31-Dec-2016




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<ul><li><p>W1292 </p><p>Barretfs Esophagus in Unscreened, Older Patients Undergoing Screening or Follow-up Colonoscopy Eric M Ward, Kenneth R I)evault, Herbert C. Wolfsen David S. Loeb, Murli Krishna, Timothy A. Woodward, Lois L Hemminger, Frances K Cayer, Sami R. Achem </p><p>Purpose: garrett's esophagus (BE) has been reported to be mme cmnmon in older patients. However, physiologic studies have demonstrated diminished esophageal sensation with aging Since current BE scmeinng recommendations focus on patients with symptmns of gastmesophageal retfux disease (GERD), (he patients at highest risk tor BE may not be screened This study seeks to determine the prevalence of BE in unscreened, older patients and the predmtabdity ot BE by GERD symptoms in this group. Methods: All patients older lban 65 years who were referred fbr outpatient colonoseopy and who had never previously undergone upper endoscopy were eligible for the study. Participants underwent upper endoscopy at the time of the scheduled colonoscopy During the procedure the presence of BE as well as other upper gastrointestinal (GI) pathology was identified. Biopsies were taken fi*om below the sqnarnocolnmnar junction (S(J) in all patients and reviewed by a single, dedicated pathologist The patients also completed a questionnaire pertaining to GERD symptoms This report describes the first 61 patients of this study. Results: The average age of the participants was 729 years with a male:female ratio of 32:29. BE was present in 5 patients (8,2%) 4 of 5 BE patients were male (BE prevalance 12.5% in males, 3 4% in kmales) The mean age of patients with BE was 70.4 years 1"he length of the metaplasia was &lt; 2 cm in 4/5. Dysplasia was not present m arty patient. Intestinal metaplasia of the gastric cardia (1MGC) was present in I0 (16%) Of the patients with BE, heartburn or regurgitation occmTed once a week or less in 4/5 and not at all in the fifth. The patient with long segment BE (8cm) was asymptomatic with the exception of rare "belching" GERD symptoms were present in half of the patients with IMGC. Other endoscopic findings included erosive esophagitis (4), para25, OR= 13) were more likely to harbor long-segment BE as </p><p>compared to younger patients (</p></li></ul>