Barrett’s Esophagus in Patients with Scleroderma

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To assess the prevalence of Barrett’s esophagus (BE) in a large cohort of patients with systemic sclerosis or scleroderma (SSc), women referred from the Mayo Clinic Arizona Rheumatology Clinic who completed EGD between 2002 and 2020 were included. Demographic and highresolution manometry data were evaluated. The diagnosis of scleroderma was confirmed by an expert rheumatologist. The BE diagnosis was confirmed by an expert gastrointestinal pathologist.

A total of 235 women with SSc underwent EGD and high-resolution manometry (HRM) was completed in 172 patients. Women with SSc with BE were significantly more likely to have scleroderma esophagus (absent contractility with hypotensive lower esophageal sphincter), on HRM than women with SSc without BE.

There were 30 patients with SSc (12.8%), with histologically-proven BE. Dysplasia was found in 13 (43.3%), 4 with indefinite, 7 with low-grade and 2 with adenocarcinoma. The incidence of any dysplasia was 5.3% per year (0.9% per year for adenocarcinoma).

In this large study on prevalence of BE in patients with SSc, yielding a prevalence of 12.8%, women with SSc with BE were significantly more likely to have absent contractility with a hypotensive lower esophageal sphincter finding on HRM. The high prevalence and incidence of dysplasia found suggest that women with SSc should be included in the screening recommendations for BE.

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