Protective benefits of columnar epithelium in Barrett's esophagus Reduced esophageal acid sensitivity

摘要: Patients with Barrett's esophagus have long been known to have a reduced sensitivity to acid. In one study, acid infusion (Bernstein) test was positive in 66% of patients with Barrett's esophagus, versus 100% of GERD controls [1]. In another study, elderly (> 65 years old) patients with Barrett's esophagus were less symptomatic than the young (symptom index 2.4±0.6 versus 4.9±1.0)[2]. Four out of five (80%) of Barrett's esophagus patients on omeprazole (20-60mg/d) had inadequate intraesophageal acid control despite the lack of heartburn [3]. In a more recent clinical study, 40% of Barrett's esophagus patients on lansoprazole (15-30 mg/d) had inadequate intraesophageal acid control despite complete symptom eradication, implying again the presence of a reduced acid sensitivity [4]. Although reduced acid sensitivity may protect the patient with Barrett's esophagus from the unpleasant symptoms of GERD, it may …