Young patients with Barrett's oesophagus experience less reflux complaints

Barrett's oesophagus can be expected to be more resistant to the effects of acidic refluxate, and, hence, it can be postulated that patients with Barrett's oesophagus experience less reflux complaints. A cross-sectional study in consecutive patients presenting with Barrett's oesophagus and reflux oesophagitis was done in order to test this hypothesis.

Patients received a standardized questionnaire, and overall and specific symptom scores were assessed on a five-point Likert scale.

Reflux oesophagitis was diagnosed in 128 patients and Barrett's oesophagus in 42. Patients with reflux oesophagitis had statistically significantly higher symptom scores than patients with Barrett's oesophagus (mean +/- SD): 9.1 +/- 6.3 vs. 6.2 +/- 5.4 (p = 0.01). The scores for heartburn and acid regurgitation were significantly higher in reflux oesophagitis, while there was a trend for epigastric pain, retrosternal pain, and vomitus. The symptom scores of patients with Barrett's oesophagus older than 60 years were not different from patients with reflux oesophagitis older than 60 years: 5.2 +/- 4.8 vs. 7.4 +/- 6.4. However, the symptom scores of patients younger than 60 years were significantly higher in those with reflux oesophagitis: 10.2 +/- 5.7 vs. 7.2 +/- 5.7 (p = 0.04). Odynophagia, heartburn, and acid regurgitation scored significantly higher in patients with reflux oesophagitis younger than 60 years as compared with Barrett patients younger than 60 years.

Patients with Barrett's oesophagus indeed suffer less from reflux complaints. However, this is only true for those younger than 60 years.