The prevalence of Barrett's esophagus in patients with chronic peptic esophageal strictures.

Both Barrett's esophagus and peptic stricture of the esophagus are consequences of chronic reflux esophagitis. Barrett's esophagus appears to be a premalignant condition, and continued histologic surveillance for dysplasia and carcinoma has been recommended for affected patients. While patients with peptic esophageal strictures and persistent reflux are at risk for the development of Barrett's epithelium, such patients often do not receive continued histologic surveillance if Barrett's epithelium is not identified on the initial endoscopic evaluation. Using endoscopic and peroral aspiration biopsy techniques, we studied the prevalence of Barrett's esophagus in 25 patients with chronic peptic esophageal strictures in whom Barrett's epithelium had not been identified previously. We found Barrett's esophagus in 11 (44%) of our 25 patients. One patient who did not have Barrett's esophagus was found to have an undifferentiated esophageal carcinoma. We conclude that patients with chronic peptic esophageal strictures frequently have Barrett's esophagus. A program of continued histologic surveillance seems advisable for such patients.