Prevalence of esophageal inlet patch and clinical characteristics of the patients

Abstract

Introduction and aims: An inlet patch (IP) is the presence of gastric columnar epithelium outside of the stomach. No studies have been conducted in Mexico on that pathology. The aim of the present study was to determine the prevalence of esophageal IP and the clinical characteristics of the patients that present it. Materials and methods: A cross-sectional study was conducted that included consecutive patients referred for endoscopy within the time frame of September 2015 to May 2016. The patients answered a questionnaire, and high-definition endoscopy with digital chromoendoscopy was performed. The prevalence of IP was identified. The chi-square test was used to compare the clinical characteristics between patients that presented with esophageal IP and those without it. Results: A total of 239 patients were included in the study. Their mean age was 53 years, and 130 (54.4%) were women. IP was found in 26 patients (10.9%), 15 of whom were men (57.7%). The main reason for referral to endoscopy was gastroesophageal reflux disease, present in 69.2% of the patients with IP and in 55.9% without IP (p = .19). The most common symptoms were heartburn and regurgitation. The former was present in 69.2% of the patients with IP and in 59.1% without IP (p = .32), and the latter was present in 65.4% of the patients with IP and 69.1% without IP (p = .7). Extraesophageal manifestation distribution was: cough in 46.2% of the patients with IP and 38% without IP (p = .45) and dysphonia in 54% with IP and 47% without IP (p = .53). Twenty-three percent of the patients with IP had Barrett's esophagus, as did 23% without IP (p = .99). Conclusions: The prevalence of IP was high. The primary referral diagnosis was gastroesophageal reflux disease. No differences were found in relation to symptoms or the presence of Barrett's esophagus between the patients with and without IP. Resumen: Introducción y objetivo: El parche de mucosa gástrica ectópica (inlet patch [IP]) es la presencia de mucosa columnar gástrica fuera del estómago. En nuestro país no se ha realizado ningún estudio sobre esta patología. El objetivo es determinar la prevalencia y características clínicas de pacientes que presentan IP en el esófago. Material y métodos: Estudio transversal. Se incluyeron pacientes consecutivos enviados a endoscopía de septiembre de 2015 a mayo de 2016. Se les aplicó un cuestionario de manifestaciones clínicas y se realizó endoscopía con equipo de alta definición y cromoendoscopía digital. Se identificó la prevalencia de IP. Se contrastaron las características clínicas del grupo afectado con el resto del grupo mediante chi cuadrada. Resultados: Se incluyeron 239 pacientes, edad promedio 53 años, 130 (54.4%) mujeres. Se encontró IP en 26 pacientes (10.9%), 15 hombres (57.7%). El principal motivo de envío fue enfermedad por reflujo gastroesofágico en 69.2% de los pacientes con IP y 55.9% sin IP (p = 0.19). Los principales síntomas fueron pirosis: 69.2% con IP, 59.1% sin IP (p = 0.32) y regurgitaciones 65.4% con IP, 69.1% sin IP (p = 0.7). La distribución de las manifestaciones extraesofágicas fueron: tos 46.2% con IP, 38% sin IP (p = 0.45) y disfonía 54% con IP, 47% sin IP (p = 0.53). Presencia de esófago de Barrett en 23.0% de pacientes con IP y 23% sin IP (p = 0.99). Conclusiones: La prevalencia de IP fue alta. El principal diagnóstico de envío fue enfermedad por reflujo gastroesofágico. No se encontraron diferencias en síntomas ni en presencia de esófago de Barrett en pacientes con y sin IP. Keywords: Esophageal inlet patch, Gastroesophageal reflux, Digital chromoendoscopy, Prevalence, Palabras clave: Parche de mucosa gástrica ectópica, Reflujo gastroesofágico, Cromoendoscopía digital, Prevalencia