The prevalence of suspected Barrett's esophagus in children and adolescents: a multicenter endoscopic study

BackgroundThe prevalence of Barrett's esophagus (BE) in young individuals is unclear.ObjectiveTo estimate the prevalence of suspected BE in children and adolescent patients undergoing endoscopy.DesignA retrospective cross-sectional study.SettingProspectively collected data in the Pediatric Clinical Outcomes Research Initiative (PEDS-CORI).PatientsWe identified patients younger than 20 years of age with suspected BE in the PEDS-CORI between 1999 and 2002; the corresponding histopathologic records were examined.Main Outcome MeasurementsWe analyzed the distribution of demographic and endoscopic risk factors for BE between cases and non-cases with and without suspected BE in bivariate and multivariable analyses.ResultsWe identified a total of 6731 patients who underwent upper endoscopy in 12 pediatric facilities. Only 17 patients had suspected BE (prevalence, 2.5 per 1000). Intestinal metaplasia was reported in only 9 of these patients (53%). Patients with suspected BE were older than patients without BE (median 14.7 vs 10.1 years; P = .011). Hiatus hernia was more commonly recorded in patients with suspected BE (11.8% vs 2.2%; P = .008). In a logistic regression model, both older age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.02-1.35) and hiatus hernia (OR 4.62, 95% CI 1.03-20.66) were independently associated with suspected BE.ConclusionsEndoscopically suspected BE is rare (<0.25%) in children and adolescents. Older age and the presence of hiatus hernia are possible risk factors for BE in this group.LimitationsLack of standardization for identifying and recording endoscopic landmarks.