Barrett's esophagus suspected at endoscopy but no specialized intestinal metaplasia on biopsy, what's next?

The American Journal of Gastroenterology
Hashim E KhandwallaHashem B El-Serag

Abstract

There are no guidelines regarding the best practice for when Barrett's esophagus (BE) is suspected but not confirmed by histology. The aim of this study was to examine the value of endoscopic follow-up for individuals with endoscopic only BE at index endoscopy. We performed a longitudinal study of patients diagnosed with suspected columnar lined esophagus (CLE) (suspected BE in the absence of histological confirmation of specialized intestinal metaplasia (IM)). We examined three possible outcomes (definite BE defined as CLE plus IM in targeted biopsies, suspected CLE, or no suspected CLE) on repeat endoscopy within 2 years after the index endoscopy and their predictors (clinical, demographic as well as endoscopists' identity). A total of 107 of 1,844 patients had suspected CLE (101 were <3 cm), and 80 underwent a repeat endoscopy within 2 years. Approximately, 71% (95% confidence interval (CI) 61.1-80.9%) had suspected CLE confirmed at repeat endoscopy and only 29% (95% CI 19.1-38.9%) had IM. The length of CLE on the index esophagogastroduodenoscopies was slightly longer among patients with definite BE on repeat endoscopy than those with suspected CLE and no IM or no CLE (1.6 cm (s.d. 1.3) vs. 1.5 cm (s.d. 1.4), and 1.4 cm (s.d...Continue Reading

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Citations

Mar 3, 2018·Expert Review of Clinical Pharmacology·Francesca Romana PonzianiEdoardo Giovanni Giannini
May 12, 2018·Annals of the New York Academy of Sciences·Andrew M BellizziRobert H Riddell
Jun 20, 2020·The American Journal of Gastroenterology·Prasad G IyerJohn B Kisiel
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Nov 4, 2015·The American Journal of Gastroenterology·Nicholas J ShaheenUNKNOWN American College of Gastroenterology
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Apr 20, 2018·Digestive Diseases and Sciences·Stuart J Spechler
Nov 4, 2020·Current Gastroenterology Reports·Nichol S MartinezDivyesh V Sejpal
Apr 15, 2015·Deutsches Ärzteblatt International·Joachim LabenzArnulf H Hölscher
Apr 24, 2021·World Journal of Gastrointestinal Oncology·Guan Sen KewKhek-Yu Ho
Apr 12, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Theresa H NguyenGyanprakash A Ketwaroo

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