Disorders associated with Barrett's esophagus

Background: Barrett's esophagus is a disease of the esophagus; however, it can be associated with different non-neoplastic and neoplastic gastrointestinal disorders. Not enough information is available in this topic. The aim of our study was the analysis of the associated gastrointestinal and extraintestinal disorders in Barrett's esophagus as recorded in the database of the First Department of Medicine and Department of Pathology of the University of Szeged. Methods: Cases bearing K21.00 or K21.90 ICD codes (respectively gastroesophageal reflux disease, without esophagitis, and gastroesophageal reflux disease, with esophagitis) were evaluated for the intervals 1998 – 2007 and 2014. Instances of functional disorder were excluded; only cases with histological diagnosis were assessed. Results: A total of 1098 patients was diagnosed with Barrett's esophagus (556 males and 542 females). The overall mean age was 55.6 years (15 to 94 years). Celiac disease (30 cases), Crohn's disease (7 cases), and ulcerative colitis (4 cases) were the most common associated non-neoplastic gastrointestinal disorders. Colorectal adenomas (28 cases) and gastric polyps (31 cases) were of note among benign gastrointestinal tumors. Gastrointestinal malignancy was demonstrated in 17 cases, with colorectal cancer (10 cases) most common. Among non-neoplastic disorders and benign tumors of extraintestinal viscera, non-toxic multinodular goiter (6 cases) and uterine leiomyoma (5 cases) were most common. Malignant extraintestinal tumors were associated to Barrett's esophagus in 36 instances (breast cancer, 9 cases; lung cancer, 5 cases; prostate cancer, 4 cases; 18 others). Conclusion: While Barrett's esophagus is an esophageal disorder, the gastrointestinal apparatus, like the body as a whole, is a unified system. Association of various disorders with Barrett's esophagus thus may not be only coincidental. Further research is needed to determine underlying pathomechanisms.