OBJECTIVE: This study evaluated whether endoscopic evidence of bile reflux was associated with the presence of Barrett\'s esophagus.
METHODS: A retrospective analysis of a prospectively maintained database comprising consecutive patients who underwent screening esophagogastroduodenoscopy was conducted. Endoscopic evidence of bile reflux was defined as the presence of bile-stained fluid in the gastric fundus. We performed multivariate analysis to identify predictive factors that differed significantly between patients with and without Barrett\'s esophagus.
RESULTS: Of 4021 patients, 922 (23%) had Barrett\'s esophagus, and 1000 (25%) showed endoscopic findings of bile reflux. Multivariate analysis revealed endoscopic evidence of bile reflux as the strongest independent factor associated with the presence of Barrett\'s esophagus (odds ratio [OR] 5.65, 95% confidence interval [CI] 4.71-6.76) in relation to the presence of hiatal hernia (OR 3.30, 95% CI 2.70-4.04) and male gender (OR 1.54, 95% CI 1.24-1.91).
CONCLUSIONS: Endoscopic evidence of bile reflux was independently associated with the presence of Barrett\'s esophagus. This finding might help identify patients at future risk of Barrett\'s esophagus who could benefit from increased endoscopy surveillance.
目的:本研究评估了内镜下胆汁反流的证据是否与Barrett食管的存在有关。
方法:对一个前瞻性维护的数据库进行回顾性分析,该数据库包括接受食管胃十二指肠镜检查筛查的连续患者。胆汁反流的内窥镜证据定义为胃底中存在胆汁染色的液体。我们进行了多变量分析,以确定有和没有Barrett食管的患者之间存在显着差异的预测因素。
结果:在4021名患者中,922(23%)患有巴雷特食管,1000(25%)显示胆汁反流的内镜发现。多变量分析显示,胆汁反流的内镜证据是与食管裂孔疝(OR3.30,95%CI2.70-4.04)和男性(OR1.54,95%CI1.24-1.91)相关的与Barrett食管(比值比[OR]5.65,95%置信区间[CI]4.71-6.76)存在的最强独立因素。
结论:内镜下胆汁反流的证据与Barrett食管的存在独立相关。这一发现可能有助于确定未来有Barrett食管风险的患者,这些患者可以从增加的内窥镜检查监测中受益。