Relationship between Kyphosis and Barrett's Esophagus in Japanese Patients

Abstract

Background Kyphosis is a risk factor for the presence of hiatal hernia, which is a strong predictor of Barrett's esophagus. However, the association between kyphosis and Barrett's esophagus has not yet been clarified. To investigate this relationship, the Cobb angle, a marker of kyphosis, was measured in patients with and without Barrett's esophagus. Methods From January 2006 to December 2010, 26 patients with long-segment Barrett's esophagus (LSBE) were retrospectively enrolled. As the comparative groups, 100 consecutive patients with shortsegment Barrett's esophagus (SSBE) and 100 consecutive control patients without Barrett's esophagus were also enrolled in this study. Cobb angles were measured on lateral chest radiographs, and kyphosis was defined as a Cobb angle of greater than 50°. Kyphosis, along with other patient characteristics, were evaluated as possible predictors for SSBE and LSBE. Results The mean Cobb angles in the non-BE, SSBE, and LSBE groups were 31.6°(95% CIs, 29.3°-33.9°), 34.8°(32.1°-37.4°) and 49.4°(44.9°-53.9°), respectively. Statistically significant differences were found between the LSBE and the other 2 groups (p<0.001). The mean Cobb angles were 33.3°±12.4°and 37.0°±14.1°, respectively in patients without and with hiatal hernia (p=0.039). Predictors for Barrett's esophagus of any length were erosive esophagitis and hiatal hernia. Kyphosis had the highest odds ratio for the presence of LSBE (OR, 1.50; 95% CI, 1.05-1.94; p=0.033). Other predictors were hiatal hernia and the absence of Helicobacter pylori infection. Conclusion Kyphosis is a risk factor for the presence of LSBE in Japanese patients.

Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta‐analysis and systematic review

“…Thirteen studies were excluded, as they did not provide sufficient data (reasons for exclusion detailed in Appendix ). Data were extracted from 83 studies; however, 11 of these studies had to be excluded from the statistical analysis as they contained data from same populations already described in other articles . Our final statistical analysis included 72 studies.…”

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Barrett Esophagus in Asia: Same Disease with Different Pattern

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Improvement of gastroesophageal reflux disease in Japanese patients with spinal kyphotic deformity who underwent surgical spinal correction

“…heartburn and regurgitation) are associated with progressive and asymmetrical degeneration of spinal elements. In particular, an increased Cobb angle increases the risk not only of symptoms but also the development of GERD . An increase in Cobb angle as a result of an increase in the number of vertebral kyphotic deformities and sagittal imbalance and a decrease in back muscle strength leads to an increase in intra‐abdominal pressure .…”