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Barrett‘s esophagus in diabetics: more frequent, but less symptomatic.

15.03.2012 by Reflux Medical

Reflux Medical
Endoscopically visible columnar lined esophagus (CLE) results from gastroesophageal Reflux. If a Biopsy obtained from CLE contains intestinal metaplasia, the condition is termed Barrett's esophagus without Dysplasia.

Association of Diabetes and HBA1c levels with gastrointestinal manifestations.
Diabetes Care 2012, ahead of print.

Tseng PH, Lee YC, Chiu HM, et al.

Barrett‘s esophagus, Esophagitis is more frequent in diabetics, but less symptomatic. This study from Taiwan compared the prevalence of GI symptoms and endoscopic abnormalities in normals vs. diabetic persons.

The study coming from Taiwan included 7770 individuals (9.3% were diabetics with HBA1c > 6.5%). The study compared the frequency of gastrointestinal symptoms and endoscopic findings (erosive Esophagitis, Barrett‘s esophagus, peptic ulcer disease, gastric neoplasms, colonic neoplasms) in diabetics vs. non-diabetic persons.

The study found:
diabetics perceive significantly less symptoms, but have significantly increased frequency of endoscopic abnormalities (Barrett‘s esophagus etc.).

Taken together, the study shows, that diabetics have increased frequency of endoscopic abnormalities (Barrett‘s esophagus, Esophagitis, gastric, colonic tumors/polyps) etc.) and a significantly lower prevalence of gastrointestinal symptoms.

Thus diabetic have it, but do not feel it. Adequate upper GI Endoscopy and large bowel Endoscopy should be offered to diabetics, irrespective of the presence or absence of symptoms.

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