The association of short segment Barrett's esophagus with intestinal metaplasia in stomach.

BACKGROUND/AIMS: The aims of this study were to investigate the presence of short segment Barrett's esophagus in people found to have tongue-like columnar mucosal protrusions in the distal esophagus and to determine the relationship between short segment Barrert's esophagus and Helicobacter pylori, gastritis and intestinal metaplasia observed in other parts of the stomach.

METHODS

The study included 50 patients (32 male, 18 female). Two biopsy specimens were taken from the antrum, at least 2 cm away from the pylorus, from the incisura angularis, corpus and cardia and four biopsy specimens were taken from tongue-like columnar protrusions (<3 cm long) above the gastroesophageal junction. Tissue samples were stained with hematoxyline-eosine, HID-Alcian blue pH 2.5 and modified Giemsa.

RESULTS

Of the 50 subjects who were found to have tongue-like columnar protrusions above the gastroesophageal junction, short segment Barrett's esophagus was detected in nine (18%). Whereas all short segment Barretti's esophagus cases were associated with chronic gastritis, Helicobacter pylori was found to be positive in five (55.5%) of them and there was intestinal metaplasia in other parts of the stomach (antrum in two patients, incisura angularis in three, antrum and cardia in one) in six (66.6%) cases. In 41 patients without short segment Barrett's esophagus 33 (80%) had chronic gastritis, 27 (66%) had Helicobacter pylori infection and eight had intestinal metaplasia in different locations (there in antrum, four in incisura angularis, one in the antrum and cardia) of the stomach.

CONCLUSIONS

An association between short segment Barrett's esophagus and intestinal metaplasia was found in different parts of the stomach. The link between intestinal metaplasia in the stomach and these metaplastic changes in the tubular esophagus requires evalation in larger and more comprehensive studies.