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Esophageal Inlet Patch: Association with Barrett’s Esophagus

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Abstract

Background

Esophageal inlet patch (IP) with heterotopic gastric mucosa is an incidental finding on esophagogastroduodenoscopy (EGD). Although IP is thought to be embryologic in nature, IP has been associated with Barrett’s esophagus (BE).

Aims

The aim of this study was to compare prevalence, symptoms, demographic factors, and esophageal testing in patients with IP and BE.

Methods

We retrospectively analyzed endoscopic findings of EGDs, high-resolution esophageal manometry and esophageal pH impedance studies from January 2010 to January 2021 at a single academic medical center. Patients were grouped by presence or absence of IP and BE.

Results

Of 27,498 patients evaluated, 1.3% had endoscopic evidence of IP and 4.9% had BE. Of 362 patients with IP, 17.1% had BE; of 1356 patients with BE, 4.6% had IP. Both IP and BE patients presented primarily with heartburn and/or regurgitation. Patients with BE and/or IP were older and had higher BMI than those without (p < 0.001). Mean lower esophageal sphincter pressure was lower and mean acid exposure time (AET) was higher in patients with IP and/or BE than those without (p < 0.05).

Conclusions

Our study reports an IP prevalence of 1.3%, with 17.1% patients having concomitant BE; and a BE prevalence of 4.9%, with 4.6% also having IP. Patients with IP alone presented with similar symptoms to patients with concomitant BE. Esophageal function testing showed that patients with either IP or BE had decreased LES pressures and increased esophageal AET. During endoscopy, patients found to have one of these findings should be carefully examined for the other.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Department of Internal Medicine, Temple University Hospital, Philadelphia, PA, USA

    Rishabh Khatri, Jay Patel & Jun Song

  2. Department of Gastroenterology, Temple University Health System, Philadelphia, PA, USA

    Zubair Malik & Henry P. Parkman

  3. Division of Gastroenterology and Hepatology, Department of Medicine, Mount Sinai West & Mount Sinai Morningside Hospitals, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Michael S. Smith

  4. Gastroenterology Section, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, Philadelphia, PA, 19140, USA

    Rishabh Khatri

Authors
  1. Rishabh Khatri
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Contributions

RK: planned study, performed chart review, organized and analyzed data, wrote manuscript. JP: performed chart review, organized data, revised manuscript. JS: performed chart review, organized data, revised manuscript. ZM: planned study, revised manuscript. MSS: planned study, revised manuscript. HPP: planned study, revised manuscript.

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Correspondence to Rishabh Khatri.

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Khatri, R., Patel, J., Song, J. et al. Esophageal Inlet Patch: Association with Barrett’s Esophagus. Dig Dis Sci 68, 3671–3678 (2023). https://doi.org/10.1007/s10620-023-08030-z

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  • DOI: https://doi.org/10.1007/s10620-023-08030-z

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