Barrett’s esophagus | Acta Medica Marisiensis

Correlation Between Helicobacter pylori, Hiatal Hernia and Barrett’s Esophagus

Macarie Melania¹, Bățagă Simona¹, Crosnoi Daniela³, Macarie I.², Török Imola¹, Georgescu D.¹,
Sârbu-Pop Silvia³

1 Clinic of Gastroenterology, Faculty of Medicine, UMPh Târgu Mureş
2 1st Medical Clinic, Faculty of Medicine, UMPh Târgu Mureş
3 Targu Mures County Clinical Emergency Hospital

Background: The incidence of adenocarcinoma of the esophagus has dramatically increased during the last 2 decades and so has the incidence of Barrett’s esophagus, one of the most important risk factors for esophageal adenocarcinoma.
Aim: The aim of this study was to determine whether infection with Helicobacter pylori is associated with a lower risk of Barrett’s esophagus development in our area, and if there is a direct correlation between hiatal hernia and Barrett’s esophagus.
Material and method: We studied a series of 4359 patients who were investigated by upper endoscopy in the Gastroenterology and Endoscopy Unit of Targu Mures County Clinical Emergency Hospital between the 1st of January 2009 and 31st of December 2009. Barrett’s esophagus was defined as the presence of specialized columnar epithelium with goblet cells in the esophagus. We compared the patients with Barrett’s esophagus with a similar serie with patients without reflux disease.
Results: In 33 patients a diagnosis of Barrett’s esophagus was established. There was a strong predominance of males. The mean age at diagnosis was 64.18 years. Helicobacter pylori was present in 17 cases (51.51%) in the control patients compared to 42.42% in patients with Barrett’s esophagus (p 0.622, Odds Ratio: 0.69 95% CI: 0.26-1.83). Hiatal hernia was present in patients with Barrett’s esophagus in 21 cases (63.63%), and in patients without reflux disease only in 5 cases (15.15%) (p<0.001, Odds Ratio: 9.8: 95% CI: 2.99-32.18).
Conclusions: A significant correlation between hiatal hernia and Barrett’s esophagus was demonstrated in our study (p<0.001).

The Usefulness of White Light Endoscopy, Narrow Band Imaging, and Magnification for the Optimization of Diagnosis in Barrett’s Esophagus

Boeriu Alina^1*, Brusnic Olga¹, Onișor Danusia¹, Pascarenco Ofelia¹, Boeriu C², Dobru Daniela¹

1 Department of Gastroenterology, University of Medicine and Pharmacy Tirgu Mures, Romania
2 University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures County Emergency Hospital, Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0002

The diagnosis of dysplasia and early neoplasia in Barrett’s esophagus by conventional endoscopy is based on a four- quadrant random biopsies protocol that is prone to sampling errors. Novel endoscopic techniques have been developed to enhance the detection of premalignant and malignant lesions by real time assessment of microvasculare architecture and mucosal structure. Chromoendoscopy with magnification has improved the visualization of lesions, but the dye application impairs a clear evaluation of vascular network. Narrow band imaging endoscopy enhances vascular imaging by using narrow bandwidth lights, with penetration to superficial mucosal structures. Different classification systems of mucosal and vascular patterns have been developed to improve the diagnostic accuracy of non-dysplastic and dysplastic BE, as well as of early esophageal cancer. This article is focused on both the clinical benefits and controversies surrounding conventional and advanced endoscopic methods used for screening and surveillance of patients with Barrett’s esophagus. Current evidence shows that the adoption of new technology in routine practice requires a high level of performance as well as the standardization of various classification systems.