NEW YORK (Reuters Health)—Barrett’s esophagus is common in women with systemic sclerosis or scleroderma (SSc) and is often accompanied by dysplasia, according to the largest study on prevalence of Barrett’s esophagus in women with SSc. In Barrett’s esophagus, chronic gastric reflux causes the lining the esophagus to be replaced by metaplastic cells that may lead to adenocarcinoma.
Among 235 women with SSc who underwent esophagogastroduodenoscopy, 30 had histologically proven Barrett’s esophagus, yielding a prevalence of 13%, researchers from Mayo Clinic, Scottsdale, Ariz., report in the American Journal of Gastroenterology.1
Patients with SSc with Barrett’s esophagus (vs. without) were significantly older (64 vs. 58 years) and more often had the limited type of SSc (87% vs. 68%), Francisco C. Ramirez, MD, and colleagues note.
Women with SSc and Barrett’s esophagus were also significantly more likely to have absent contractility with hypotensive lower esophageal sphincter findings on high-resolution manometry, suggesting greater predisposition to gastroesophageal reflux disease (GERD), they say. All of the women with SSc and Barrett’s esophagus had GERD symptoms as did 92% of women with SSc without Barrett’s esophagus.
Of note, say the researchers, 13 (43%) of the 30 women with SSc and Barrett’s esophagus had dysplasia, including four (12%) with indefinite dysplasia, seven (21%) with low-grade dysplasia and two (6%) with esophageal adenocarcinoma.
“The prevalence of any dysplasia including esophageal adenocarcinoma was estimated to be 43% and a calculated incidence of 5.3% per year (0.9% per year for adenocarcinoma),” the researchers note in their article.
It’s well-known that dysplastic Barrett’s esophagus is the best predictor for progression into esophageal adenocarcinoma, they point out. “These data suggest that women with SSc should be included in the screening recommendations for Barrett’s esophagus and treated accordingly if dysplasia is found,” they conclude.
The study had no financial support and the authors have declared no competing interests.
- Snyder DL, Crowell MD, Kahn A, et al. Prevalence of Barrett’s esophagus in female patients with scleroderma. Am J Gastroenterol. 2021 Jan 7. Online ahead of print.