Association between endoscopic evidence of bile reflux and Barrett's esophagus: A large-scale case-control study.

Barrett's esophagus Bile reflux Gastroesophageal reflux disease Hiatal hernia Surveillance

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
16 Dec 2023
Historique:
received: 25 07 2023
revised: 02 11 2023
accepted: 30 11 2023
medline: 18 12 2023
pubmed: 18 12 2023
entrez: 17 12 2023
Statut: aheadofprint

Résumé

Although bile reflux plays an important role in the development of Barrett's esophagus, the relationship between endoscopic findings of bile reflux and Barrett's esophagus remains unclear. This study evaluated whether endoscopic evidence of bile reflux was associated with the presence of Barrett's esophagus. A retrospective analysis of a prospectively maintained database comprising consecutive patients who underwent screening esophagogastroduodenoscopy was conducted. Endoscopic evidence of bile reflux was defined as the presence of bile-stained fluid in the gastric fundus. We performed multivariate analysis to identify predictive factors that differed significantly between patients with and without Barrett's esophagus. Of 4021 patients, 922 (23%) had Barrett's esophagus, and 1000 (25%) showed endoscopic findings of bile reflux. Multivariate analysis revealed endoscopic evidence of bile reflux as the strongest independent factor associated with the presence of Barrett's esophagus (odds ratio [OR] 5.65, 95% confidence interval [CI] 4.71-6.76) in relation to the presence of hiatal hernia (OR 3.30, 95% CI 2.70-4.04) and male gender (OR 1.54, 95% CI 1.24-1.91). Endoscopic evidence of bile reflux was independently associated with the presence of Barrett's esophagus. This finding might help identify patients at future risk of Barrett's esophagus who could benefit from increased endoscopy surveillance.

Sections du résumé

BACKGROUND BACKGROUND
Although bile reflux plays an important role in the development of Barrett's esophagus, the relationship between endoscopic findings of bile reflux and Barrett's esophagus remains unclear.
OBJECTIVE OBJECTIVE
This study evaluated whether endoscopic evidence of bile reflux was associated with the presence of Barrett's esophagus.
METHODS METHODS
A retrospective analysis of a prospectively maintained database comprising consecutive patients who underwent screening esophagogastroduodenoscopy was conducted. Endoscopic evidence of bile reflux was defined as the presence of bile-stained fluid in the gastric fundus. We performed multivariate analysis to identify predictive factors that differed significantly between patients with and without Barrett's esophagus.
RESULTS RESULTS
Of 4021 patients, 922 (23%) had Barrett's esophagus, and 1000 (25%) showed endoscopic findings of bile reflux. Multivariate analysis revealed endoscopic evidence of bile reflux as the strongest independent factor associated with the presence of Barrett's esophagus (odds ratio [OR] 5.65, 95% confidence interval [CI] 4.71-6.76) in relation to the presence of hiatal hernia (OR 3.30, 95% CI 2.70-4.04) and male gender (OR 1.54, 95% CI 1.24-1.91).
CONCLUSIONS CONCLUSIONS
Endoscopic evidence of bile reflux was independently associated with the presence of Barrett's esophagus. This finding might help identify patients at future risk of Barrett's esophagus who could benefit from increased endoscopy surveillance.

Identifiants

pubmed: 38105146
pii: S1590-8658(23)01080-0
doi: 10.1016/j.dld.2023.11.042
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest None.

Auteurs

Yugo Iwaya (Y)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Advanced Therapeutic Endoscopy, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: yiwaya@shinshu-u.ac.jp.

Kenichi Goda (K)

Department of Gastroenterology, School of Medicine, Dokkyo Medical University, Tochigi, Japan.

Satoko Kako (S)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Honoka Hattori (H)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Takayuki Miyazawa (T)

Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan.

Daichi Hara (D)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Kenta Hashigami (K)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Atsuhiro Hirayama (A)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Takuma Okamura (T)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan.

Tadanobu Nagaya (T)

Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan.

Takeji Umemura (T)

Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan; Department of Advanced Therapeutic Endoscopy, Shinshu University School of Medicine, Matsumoto, Japan.

Classifications MeSH