J Neurogastroenterol Motil.
2023 Jan;29(1):31-37. 10.5056/jnm21255.
Esophageal Hypocontractile Disorders and Hiatal Hernia Size Are Predictors for Long Segment Barrett’s Esophagus
- Affiliations
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- 1Department of Medicine, Division of Gastroenterology and Hepatology, Esophageal and Swallowing Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
- 2Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA
- 3Department of Gastroenterology, ABC Medical Center PMG, Santa Fe, Contadero, Cuajimalpa de Morelos, Mexico
- 4Deapartment of Digestive Physiology and Motility Laboratory, Medical Biological Research Institute, University of Veracruz, Veracruz, Mexico
- 5Department of Medicine, Division of Gastroenterology and Hepatology, Digestive Disease Center, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA
- 6Department of Medicine, Division of Gastroenterology and Hepatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
- KMID: 2537937
- DOI: http://doi.org/10.5056/jnm21255
Abstract
- Background/Aims
Presently, there is paucity of information about clinical predictors, especially esophageal motor abnormalities, for long segment Barrett’s esophagus (LSBE) as compared with short segment Barrett’s esophagus (SSBE). The aims of this study are to compare the frequency of esophageal function abnormalities between patients with LSBE and those with SSBE and to determine their clinical predictors.
Methods
This was a multicenter cohort study that included all patients with a diagnosis of BE who underwent high-resolution esophageal manometry. Motility disorders were categorized as hypercontractile disorders or hypocontractile disorders and their frequency was compared between patients with LSBE and those with SSBE. Multivariable logistic regression modeling was used to calculate the odds of being diagnosed with LSBE relative to SSBE for demographics, comorbidities, medication use, endoscopic findings, and the type of motility disorders.
Results
A total of 148 patients with BE were identified, of which 89 (60.1%) had SSBE and 59 (39.9%) LSBE. Patients with LSBE had a significantly larger hiatal hernia and higher likelihood of erosive esophagitis than patients with SSBE (P = 0.002). Patients with LSBE had a significantly lower mean LES resting pressure, distal contractile integral, distal latency, and significantly higher failed swallows and hypocontractile motility disorders than those with SSBE (P < 0.05). Hiatal hernia and hypocontractile motility disorder increased the odds of LSBE by 38.0% and 242.0%, as opposed to SSBE.
Conclusions
The presence of a hypocontractile motility disorder increased the risk for LSBE. Furthermore, the risk for LSBE was directly associated with the length of the hiatal hernia.
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