Prevalence of Complicated Gastroesophageal Reflux Disease and Barrett’s Esophagus Among Racial Groups in a Multi-Center Consortium

Abstract

Aims The Clinical Outcomes Research Initiative database was used to evaluate ethnic trends in complicated reflux disease and suspected Barrett’s esophagus among various racial groups. Methods Endoscopic findings for procedures performed January 2000–December 2005 for any indication and for reflux-related indications were reviewed by racial group. Results Of 280,075 procedures examined, Hispanics were the most likely to have esophagitis (Hispanic 19.6%, white 17.3%, black 15.8%, Asian/Pacific Islander 9.5%, P-value < 0.0001), and white subjects were most likely to have suspected BE (white 5.0%, Hispanic 2.9%, Asian/Pacific Islander 1.8%, black 1.5%, P-value < 0.0001). Endoscopies performed for reflux-related indications had similar trends for esophagitis and esophageal stricture. Among reflux/Barrett’s screening procedures adjusted for age and gender, Hispanics were most likely to have esophagitis (OR = 1.28, P-value < 0.0001) compared to Caucasians. Conclusion Our results demonstrate an association of suspected Barrett’s esophagus and stricture with white patients and esophagitis with Hispanic patients. These findings need to be followed-up with further study.

African Americans with Barrett’s Esophagus Are Less Likely to Have Dysplasia at Biopsy

“…Recent work from the CORI database indicates that nHw are more likely to have a hiatal hernia and esophageal stricture than AA patients [16]. Other investigators have observed that hiatal hernia was associated with an increased risk of LSBE [14].…”

“…The subject of racial and ethnic discrepancies in the BE frequency has been addressed in prior studies [8][9][10][11][12][13][14][15][16]. However, risk ratios for the presence of histologic BE in AA has been reported less frequently [8,[14][15][16]. In two studies from the Clinical Outcomes Research Initiative (CORI) endoscopic database, odds ratios for the presence of BE were reported [8,16].…”

“…However, risk ratios for the presence of histologic BE in AA has been reported less frequently [8,[14][15][16]. In two studies from the Clinical Outcomes Research Initiative (CORI) endoscopic database, odds ratios for the presence of BE were reported [8,16]. Non-Hispanic blacks were found to have a reduced risk of endoscopic findings suspicious for BE when compared to nHw.…”

Long-term remission of nondysplastic Barrett's esophagus after multipolar electrocoagulation ablation: report of 139 patients with 10 years of follow-up

“…A lower incidence of BE has been described in Hispanic Americans compared with the non-Hispanic white population, but whether BE in such patients follows a different natural history is incompletely understood. 30,31 As noted in the Methods section, 16 patients were excluded from the primary analysis because they did not have adequate follow-up. These patients had significantly longer-segment BE and required more ablative sessions than the study cohort.…”

African American ethnicity is not associated with development of Barrett's oesophagus after erosive oesophagitis

“…Barrett's oesophagus is a metaplastic change, following injury caused by reflux of acid and bile, in which one kind of fully differentiated cell replaces another [9]. Principal risk factors for BE development include duration of gastroesophageal reflux disease (GERD), hiatal hernia, male sex, family history of BE, obesity and cigarette smoking while CagA+ Helicobacter pylori colonization, regular aspirin or nonsteroidal anti-inflammatory drug use as well as African American race are associated with decreased risk [10][11][12][13][14][15][16][17][18][19][20][21].…”