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Esophageal Inlet Patch: Association with Barrett's Esophagus
Rishabh Khatri1,2, Jay Patel3, Jun Song3
1Department of Internal Medicine, Temple University Hospital, Philadelphia, PA, USA. Rishabh.Khatri@tuhs.temple.edu.
Digestive Diseases and Sciences
|July 15, 2023
Summary
Esophageal inlet patch (IP) and Barrett's esophagus (BE) share similar symptoms and risk factors. Patients with IP or BE show decreased LES pressure and increased acid exposure, warranting careful examination for both conditions.
Area of Science:
- Gastroenterology
- Esophageal Diseases
- Endoscopy
Background:
- Esophageal inlet patch (IP) with heterotopic gastric mucosa is an incidental finding during esophagogastroduodenoscopy (EGD).
- While considered embryologic, IP has been linked to Barrett's esophagus (BE).
Purpose of the Study:
- To compare the prevalence, symptoms, demographics, and esophageal testing results between patients with IP and BE.
- To investigate the association between IP and BE.
Main Methods:
- Retrospective analysis of EGDs, high-resolution esophageal manometry, and esophageal pH impedance studies from January 2010 to January 2021.
- Patients were categorized based on the presence or absence of IP and BE.
Main Results:
- Prevalence: 1.3% for IP, 4.9% for BE. Concomitant findings: 17.1% of IP patients had BE; 4.6% of BE patients had IP.
- Symptoms: Heartburn and regurgitation were primary symptoms for both IP and BE groups.
- Esophageal testing: Patients with IP and/or BE exhibited lower LES pressure and higher acid exposure time (AET) compared to controls.
Conclusions:
- IP and BE share similar clinical presentations and risk factors (older age, higher BMI).
- Both conditions are associated with impaired esophageal function, including reduced LES pressure and increased AET.
- Endoscopic identification of either IP or BE necessitates a thorough examination for the other condition.
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