Incongruence between Histologic and Endoscopic Diagnoses of Barrett’s Esophagus Using Transnasal Esophagoscopy

INTRODUCTION
Over recent years, transnasal esophagoscopy (TNE) has been identified as a useful tool for office-based diagnosis of various esophageal pathology, including esophageal strictures, esophagitis, and Barrett’s esophagus.  Unlike traditional flexible esophagoscopy, TNE requires no sedation and is performed using only topical nasal anesthesia with the patient in a seated position.

The prevalence of Barrett’s esophagus among patients with gastroesophageal reflux disease (GERD) is estimated to range from 5% to 20%.4,5 Little is known about the prevalence of Barrett’s esophagus in patients with laryngopharyngeal reflux (LPR). One study with limited sample size (n = 58) found Barrett’s metaplasia in 7% of patients with LPR,  but no further studies are available to corroborate this data. The goal of this study was to determine the rate of Barrett’s metaplasia among a large series of consecutive patients with LPR who had undergone TNE surveillance, with a special emphasis on the relationship between endoscopic findings and histopathologic results.

CONCLUSION
In conclusion, the current study demonstrates a low rate (3%) of biopsy confirmed Barrett’s esophagus among patients with LPR with a higher rate (10%) of Barrett’s findings on endoscopy. This incongruence between endoscopic and histologic diagnoses warrants further study.

Read: Incongruence between Histologic and Endoscopic Diagnoses of Barrett’s Esophagus Using Transnasal Esophagoscopy
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Stacey L. Halum, MD; Gregory N. Postma, MD; Dwight D. Bates, MD; Jamie A. Koufman, MD

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