Prevalence of Barrett's esophagus in Korea

Background: In contrast to Western countries, the prevalence of Barrett's esophagus (BE) is still believed to be very low in the Far East. The aim of the present paper was to assess the prevalence of BE in Korea. Methods: Nine hundred and ninety-two consecutive patients undergoing their first diagnostic upper gastrointestinal endoscopies due to various indications were included from four university hospitals in Korea. Esophagus of each patient was examined during insertion of the endoscope with minimum air inflation. From subjects who were found, during endoscopy, to have columnar-lined esophagus, at least two biopsy samples were taken from the columnar epithelium. Patients exhibiting specialized columnar epithelium on histological examination were diagnosed as having BE. Results: Among 992 patients, 108 cases (10.9%) were endoscopically diagnosed as short-segment BE, and three cases (0.3%) were endoscopically diagnosed as long-segment BE. However, only 36 patients (3.6%) met the histological criteria for BE. Among these patients, only one (0.1%) was histologically diagnosed as having long-segment BE. Reflux esophagitis, mostly in a mild degree, was found in 25.0% of the BE group, and 8.6% of the non-BE group (P = 0.0022). Hiatal hernias were more commonly found in the BE group than in the non-BE group (22.2% vs 8.9%, P = 0.0163). Conclusions: Although the prevalence of BE in Korea appears to be lower than the reported rates from Western countries, it may not be as low as was previously thought.