Clinical features and investigations in patients with columnar-lined oesophagus

Abstract

Background It is unclear why some patients with a columnar-lined oesophagus present with intestinal metaplasia and others do not. The physiopathological and clinical implications of the length of the metaplastic segment are also controversial. The aim of the study was to determine whether the length of the metaplasia and the presence of intestinal epithelium are related to the clinical, manometric and pHmetric data in patients with columnar-lined oesophagus. Methods A comparison of clinical, endoscopic, pathological, manometric and pHmetric data was made between patients with columnar-lined oesophagus of 3–5 cm (n = 31) and those with a metaplastic segment of 5 cm or more (n = 28); the same comparison was made between patients who had specialized intestinal metaplasia (n = 37) and those who did not (n = 22). Results No significant difference was found in any of the variables studied except for associated inflammatory lesions above the columnar epithelium which were more frequent in patients with a shorter metaplastic segment (P < 0·05). Conclusion Neither the length of the metaplastic segment nor the presence of intestinal metaplasia was related to a more evolved gastro-oesophageal reflux disease, a poorer oesophageal clearing function or higher acid reflux rates. © 1998 British Journal of Surgery Society Ltd