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Prevalence of barretts esophagus and dysplasia in an unselected gerd population using a battery powered endoscope operated by a nurse practitioner



Prevalence of barretts esophagus and dysplasia in an unselected gerd population using a battery powered endoscope operated by a nurse practitioner



Digestive Disease Week Abstracts & Itinerary Planner : Abstract No M1756



Background: The prevalence of Barrett's esophagus in the general heartburn population is unknown. A BPE has been prospectively evaluated and found to be sensitive and specific in detecting columnar lined esophagus (CLE). A NP was trained to use a BPE to perform screening esophagoscopy in a free standing clinic setting. Methods: General advertising was used to make people aware of the esophageal screening clinic. Inclusion criteria: adult heartburn patients without dyspepsia or dysphagia. Patients (pts) underwent esophagoscopy without sedation. Patients with significant findings, (CLE > 5 mm, esophagitis sufficient to obstruct the view of the GEJ, nodules and rings) were referred to a gastroenterologist for standard EGD. Results: 240 pts were eligible but 13 patients (5%) were unable to tolerate esophageal intubation due to fear/gagging. Of the remaining 227 pts who completed the esophagoscopy, 99% were willing to repeat the procedure. Mean time of examination was 4 minutes. Findings included: see table. The sensitivity and specificity of the NP for detecting CLE was 92% and 82%, respectively. One LGD converted to HGD after 6 months. Overall 20% of BE patients had dysplasia and 8% had or developed HGD. Conclusion: Community based screening with trained nursed practitioner, a small caliber endoscope and no sedation, may be an accurate and effective screening tool for Barrett's detection in the general heartburn patient population. The prevalence of dysplasia is remarkably high although the reasons for this are unknown.

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