Primary Motility  Disorders of the  Esophagus
 The Esophageal
 Mucosa
 The
 Esophagogastric  Junction
 Barrett's
 Esophagus

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OESO©2015
 
Volume: Barrett's Esophagus
Chapter: Short Barrett's esophagus
 

Is "minimal" or ultra-short segment Barrett's esophagus a consistent reality?

J.E. Richter (Cleveland)

This authority does not believe that the ultra-short Barrett's esophagus exists. Rather, biopsies taken below a normal Z-line can identify specialized intestinal metaplasia (IM), but it has demographic patterns very different from classic long segment Barrett's. That is, there is a high prevalence of women, non-white ethnic races, and many of these patients do not have classic heartburn symptoms. Recent studies from our laboratory show that most of these patients have specialized IM associated with carditis and H. pylori infection [1]. This is also confirmed by a new cytokeratin staining process, which helps to identify IM arising from the esophagus versus the stomach [2]. This author strongly believes the term ultrashort Barrett's esophagus should no longer be used. A more appropriate term is specialized IM below a normal esophagogastric junction.

References

1. Goldblum JR, Vicari JJ, Falk GW, et al. Inflammation and intestinal metaplasia of the gastric cardia: the role of GER and H. pylori infection. Gastroenterology 1998;114:633-639.

2. Ormsby AH, Vaezi MF, Richter JE, et al. Cytokeratin immunoreactivity patterns in the diagnosis of short-segment Barrett's esophagus. Gastroenterology 2000;119:683-690.


Publication date: August 2003 OESO©2015