Diagnostic inconsistencies in Barrett's esophagus

Suzy L. Kim, J. Patrick Waring, Stuart Jon Spechler, Richard E. Sampliner, Wilhelm G. Doos, William F. Krol, William O. Williford

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Background/Aims: Few studies have compared the precision of various diagnostic tests used to determine the presence of Barrett's esophagus. The aim of this study was to compare the results of histological, endoscopic, and manometric tests for patients with Barrett's esophagus in two closely spaced examinations. Methods: In a Veterans Administration Cooperative Study, 192 patients with complicated gastroesophageal reflux disease had esophageal manometry and endoscopy performed at baseline and after 6 weeks. At each examination, the endoscopist localized the most proximal level of Barrett's epithelium and the lower esophageal sphincter and obtained esophageal biopsy specimens. Results: One hundred sixteen patients met the criteria for Barrett's esophagus on at least one of the two endoscopic examinations. Among patients with specialized columnar epithelium, 20% had specialized columnar epithelium found on only one of the two examinations. Although the mean lower esophageal sphincter level did not change, approximately 10% of patients had a change ≥4 cm on endoscopy and manometry between examinations. This led to an apparent change in the diagnosis in 18% of patients with Barrett's esophagus. Conclusions: From one endoscopic examination to another, inconsistencies in the ability to detect specialized columnar epithelium are common. This may lead to substantial problems in establishing an accurate diagnosis of Barrett's esophagus.

Original languageEnglish (US)
Pages (from-to)945-949
Number of pages5
JournalGastroenterology
Volume107
Issue number4
StatePublished - 1994

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Barrett Esophagus
Lower Esophageal Sphincter
Epithelium
Manometry
Endoscopy
United States Department of Veterans Affairs
Gastroesophageal Reflux
Routine Diagnostic Tests
Biopsy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kim, S. L., Waring, J. P., Spechler, S. J., Sampliner, R. E., Doos, W. G., Krol, W. F., & Williford, W. O. (1994). Diagnostic inconsistencies in Barrett's esophagus. Gastroenterology, 107(4), 945-949.

Diagnostic inconsistencies in Barrett's esophagus. / Kim, Suzy L.; Waring, J. Patrick; Spechler, Stuart Jon; Sampliner, Richard E.; Doos, Wilhelm G.; Krol, William F.; Williford, William O.

In: Gastroenterology, Vol. 107, No. 4, 1994, p. 945-949.

Research output: Contribution to journalArticle

Kim, SL, Waring, JP, Spechler, SJ, Sampliner, RE, Doos, WG, Krol, WF & Williford, WO 1994, 'Diagnostic inconsistencies in Barrett's esophagus', Gastroenterology, vol. 107, no. 4, pp. 945-949.
Kim SL, Waring JP, Spechler SJ, Sampliner RE, Doos WG, Krol WF et al. Diagnostic inconsistencies in Barrett's esophagus. Gastroenterology. 1994;107(4):945-949.
Kim, Suzy L. ; Waring, J. Patrick ; Spechler, Stuart Jon ; Sampliner, Richard E. ; Doos, Wilhelm G. ; Krol, William F. ; Williford, William O. / Diagnostic inconsistencies in Barrett's esophagus. In: Gastroenterology. 1994 ; Vol. 107, No. 4. pp. 945-949.
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