Barrett's Esophagus Common in Women With Scleroderma

By Reuters Staff

January 19, 2021

NEW YORK (Reuters Health) - Barrett's esophagus (BE) is common in women with systemic sclerosis or scleroderma (SSc) and is often accompanied by dysplasia, according to the largest study on prevalence of BE in women with SSc.

Among 235 women with SSc who underwent esophagogastroduodenoscopy (EGD), 30 had histologically proven BE, yielding a prevalence of 13%, researchers from Mayo Clinic, in Scottsdale, Arizona, report in the American Journal of Gastroenterology.

Patients with SSc with BE (versus without) were significantly older (64 vs. 58 years) and more often had the limited type of SSc (87% vs. 68%), Dr. Francisco Ramirez and colleagues note.

Women with SSc and BE 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 BE had GERD symptoms as did 92% of women with SSc without BE.

Of note, say the researchers, 13 (43%) of the 30 women with SSc and BE had dysplasia, including four (12%) with indefinite dysplasia, seven (21%) with low-grade dysplasia and two (6%) with esophageal adenocarcinoma (EAC).

"The prevalence of any dysplasia including EAC 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 BE is the best predictor for progression into EAC, they point out. "These data suggest that women with SSc should be included in the screening recommendations for BE and treated accordingly if dysplasia is found," they conclude.

The study had no financial support and the authors have declared no competing interests.

SOURCE: American Journal of Gastroenterology, online January 7, 2021.