Original articleClinical endoscopyScreening for Barrett's esophagus in asymptomatic women
Section snippets
Methods
Approval was obtained from the Human Subjects Panel at Stanford University and the VA Palo Alto Health Care System for this study. During the first phase of the project, women undergoing routine screening colonoscopy were invited to undergo upper endoscopy directly following the colonoscopy. Funding for the upper endoscopic examinations was obtained by Dr. Gerson via the Estelle Buel Simon Fund at Stanford University. Potential candidates were sent a letter of invitation and were required to
Results
We invited 252 patients to participate in the study. A flow diagram detailing the subjects' progression through the study is shown in Figure 1. Seventeen (7%) patients refused to participate (all patients refusing were in the screening colonoscopy cohort) and 31 (12%) were excluded because of daily or weekly GERD symptoms (13 from the screening colonoscopy cohort and 18 from the pre–bariatric surgery group). One hundred twenty-six patients (50%) agreed to participate, including 61 patients
Discussion
BE is a metaplastic alteration of the distal esophageal epithelium to specialized intestinal epithelium and is thought to arise after injury of the squamous epithelium with repair occurring via a more acid-tolerant columnar epithelium. Canine models have supported the concept of mucosal injury leading to tissue regeneration via metaplastic columnar epithelium.16 In most cases, injury to the squamous epithelium occurs because of acid reflux disease, a common disorder occurring in approximately
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DISCLOSURE: The following author disclosed financial relationships relevant to this publication: L. B. Gerson: speaker for AstraZeneca, Takeda Pharmaceuticals, and Santarus. Supported by a grant from the Estelle Buel Simon Fund at Stanford University and an American Gastroenterological Association Research Scholar Award to L. B. Gerson. The other author disclosed no financial relationships relevant to this publication.