J Neurogastroenterol Motil.  2018 Apr;24(2):216-225. 10.5056/jnm17090.

Esophageal Motor Disorders Are a Strong and Independant Associated Factor of Barrett's Esophagus

• Bazin C
• Benezech A
• Alessandrini M
• Grimaud JC
• Vitton V

• KMID: 2413097
• DOI: http://doi.org/10.5056/jnm17090

Abstract

BACKGROUND/AIMS
Esophageal motor disorder (EMD) has been shown to be associated with gastroesophageal reflux disease (GERD). However, the association of EMD with a Barrett's esophagus (BE) is controversial. Our objective was to evaluate whether the presence of EMD was an independent factor associated with BE.
METHODS
A retrospective case-control study was conducted in GERD patients who all had oeso-gastroduodenal endoscopy and high-resolution esophageal manometry. The clinical data collected was known or potential risk factors for BE: male gender, smoking and alcohol consumption, age, body mass index, presence of hiatal hernia, frequency, and age of GERD. EMD were classified according to the Chicago classification into: ineffective motor syndrome, fragmented peristalsis and absence of peristalsis, lower esophageal sphincter hypotonia.
RESULTS
Two hundred and one patients (101 in the GERD + BE group and 100 in the GERD without BE) were included. In univariate analysis, male gender, alcohol consumption, presence of hiatal hernia, and EMD appeared to be associated with the presence of BE. In a multivariate analysis, 3 independent factors were identified: the presence of EMD (odds ratio [OR], 3.99; 95% confidence interval [CI], 1.71-9.28; P = 0.001), the presence of hiatal hernia (OR, 5.60; 95% CI, 2.45-12.76; P < 0.001), Helicobacter pylori infection (OR, 0.08; 95% CI, 0.01-0.84; P = 0.035).
CONCLUSIONS
The presence of EMD (particularly ineffective motor syndrome and lower esophageal sphincter hypotonia) is a strong independent associated factor of BE. Searching systematically for an EMD in patients suffering from GERD could be a new strategy to organize the endoscopic follow-up.

Keyword

Barrett esophagus; Esophageal motility disorders; Gastroesophageal reflux

MeSH Terms

Alcohol Drinking
Barrett Esophagus*
Body Mass Index
Case-Control Studies
Classification
Endoscopy
Esophageal Motility Disorders
Esophageal Sphincter, Lower
Follow-Up Studies
Gastroesophageal Reflux
Helicobacter pylori
Hernia, Hiatal
Humans
Male
Manometry
Motor Disorders*
Multivariate Analysis
Muscle Hypotonia
Peristalsis
Retrospective Studies
Risk Factors
Smoke
Smoking
Smoke