BARRETT’S ESOPHAGUS AND ASSOCIATED RISK FACTORS AMONG PATIENTS IN NORTH OF IRAQ

Ali Abdulghani Ramadhan

Ali Abdulghani Ramadhan Department of Medicine, College of Medicine, University of Duhok, Duhok, Iraq.

Keywords: Barrett’s esophagus, reflux disease, upped endoscopy, Duhok

Abstract

https://doi.org/10.31386/dmj.2025.19.2.3

Background: Gastroesophageal reflux disease is a common condition affecting the upper gastrointestinal tract and results in substantial health loss. Its burden is increasing due to global population aging and growth. Barrett’s esophagus is an important complication of this disease and is the precursor of esophageal adenocarcinoma which remains a malignancy with poor prognosis.

Objective: To determine the prevalence of Barrett’s esophagus and its risk factors in Duhok, Iraq.

Patients and methods: This prospective study extended from February 2016 to August 2024 in 3 health facilities in Duhok-Iraq. It included 10000 patients referred to diagnostic endoscopy for any indication. The endoscopy was done using high definition gastroscopes and when Barrett’s esophagus was suspected on endoscopy, biopsies were taken using Seatle protocol.

Results: The age range was 18-92 years (mean=44.3 years). The prevalence of BE was 0.5% on histopathology and 1.4% on endoscopy. Risk factors associated with BE were erosive reflux disease (OR= 23.7, P-value <0.0001), hiatus hernia (OR= 10.9, P-value <0.0001), smoking (OR= 2.8, P-value 0.0001), male sex (OR= 2.5, P-value 0.001), obesity (OR= 1.9, P-value 0.02) and age more than 50 years (OR= 1.8, P-value 0.03). Alcohol intake was not associated with BE (P-value 0.07).

Conclusion: The prevalence of BE in our area is lower than the rates reported in the literature. The risk factors for BE are erosive reflux disease, hiatus hernia, smoking, male sex, obesity and age more than 50 years. Alcohol intake was not associated with BE.

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