Title : Prevalence and associated risk factors of Barretts esophagus in patients undergoing OGD scopy in a tertiary care hospital
Abstract:
Barrett’s esophagus is a metaplastic change in the lining mucosa of the esophagus in response to chronic gastroesophageal reflux. In this condition, the squamous epithelium lining the lower portion of the esophagus is replaced by intestinal columnar epithelium. The prevalence and risk factors of Barret’s esophagus in a state like Kerala is unclear. Studies report a wide range of Barret’s esophagus in Asian countries. But when compared to whites, the prevalence of the condition is much less. It may be attributed to both genetics and environmental factors. The prevalence of Barret’s esophagus and that of GERD varies among ethnic groups. The past decades have witnessed an increasing prevalence of BE in the world. The aim of the study is to assess the prevalence of Barret’s esophagus in patients undergoing OGDscopy for various indications in Amala Institute of Medical Sciences,Thrissur and also to find out the risk factors leading to Barret’s esophagus in these people. Several risk factors are thought to be associated with the development of BE like increase in age, sex, increase in BMI, heartburn, gastric regurgitation, smoking, alcoholism etc. The diagnosis of BE is confirmed by histopathological examination. In this study we took biopsy from those patients who had features doubtful of BE in OGDscopy. Our cross sectional study consist of 388 patients with a mean age of 54.45 years. 28 out of 388 patients, that is 7.2% of patients were having features doubtful of BE in OGDscopy. Endoscopically, Columnar epithelium has a characteristic reddish color and velvet like texture that can be distinguished readily from normal esophageal squamous epithelium, which is pale and glossy and the columnar epithelium must line 1cm or greater of the distal esophagus. Only if this criteria is met, a biopsy is taken from these sites.
From this study we concluded that
1.The prevalence of Barrett’s esophagus in patients undergoing OGDscopy for various indications in a tertiary care teaching hospital like Amala Institute of Medical Sciences is 4.6%.
2.Patients who had a BMI > 25 and those patients who had features of GERD like regurgitation & heartburn are found to be risk factors for the development of BE in this study.
3.Other factors like age, sex, heartburn, smoking and alcoholism are not found to have an association with the development of BE.
