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Original article
Barrett's oesophagus length is established at the time of initial endoscopy and does not change over time: results from a large multicentre cohort
  1. Fouad J Moawad1,
  2. Patrick E Young1,
  3. Srinivas Gaddam2,
  4. Prashanth Vennalaganti3,
  5. Prashanthi N Thota4,
  6. John Vargo4,
  7. Brooks D Cash5,
  8. Gary W Falk6,
  9. Richard E Sampliner7,
  10. David Lieberman8,
  11. Prateek Sharma3,9
  1. 1Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
  2. 2Gastroenterology Division, Washington University in St Louis, St Louis, Missouri, USA
  3. 3Division of Gastroenterology, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA
  4. 4Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
  5. 5Division of Gastroenterology, University of South Alabama, Mobile, Alabama, USA
  6. 6Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  7. 7Division of Gastroenterology and Hepatology, University of Arizona, Tucson, Arizona, USA
  8. 8Division of Gastroenterology and Hepatology, Oregon Health & Sciences University, Portland, Oregon, USA
  9. 9Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Kansas, USA
  1. Correspondence to Dr Fouad J Moawad, Gastroenterology Service, Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA; Fouad.Moawad{at}us.army.mil.

Abstract

Objective It is unclear whether Barrett's oesophagus (BO) length changes over time or whether the full length of the segment is established at the onset of disease recognition. The objectives of this study were to evaluate the association of age and BO length and to evaluate the changes in BO length over time.

Design This is a prospective, multicentre cohort study involving patients with BO from five centres. Patients were divided into groups based on the decade of initial diagnosis of BO. The mean BO length and the mean change in BO length were calculated for each age decade. The mean change in BO length was also calculated between the index endoscopy and the last surveillance endoscopy.

Results 3635 patients with BO were included in the study: 87.8% men, 92.8% Caucasians, mean age 60.9 years and mean BO length 3.5 cm. The mean change in BO length was 0.9 cm. The mean BO length did not significantly change for each age category: <30 years (4.6 cm), 30–39.9 years (3.2 cm), 40–49.9 years (3.1 cm), 50–59.9 years (3.1 cm), 60–69.9 years (3.6 cm), 70–79.7 (4.0 cm) and >80 years (4.5 cm), p=0.47. On subgroup analysis of patients with non-dysplastic BO who had at least 1 year of endoscopic follow up, there was a significant decrease in mean change in BO length across age categories ranging from +1.7 to −0.8 cm, p=0.03.

Conclusions There was no significant difference in BO length by age category in decades. In addition, the change in BO length from index to follow-up endoscopy was similar among patients >30 years. These findings suggest that a patient's BO segment length attains its full extent by the time of the initial endoscopic examination.

  • BARRETT'S OESOPHAGUS
  • ACID-RELATED DISEASES
  • BARRETT'S METAPLASIA
  • BARRETT'S CARCINOMA

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