GERD symptoms and hiatal hernia are risk factors for Barrett's esophagus

NEW YORK (Reuters Health) – Long-standing of gastroesophageal reflux disease (GERD), hiatal hernia, and possibly alcohol use are associated with the development of Barrett's esophagus and esophagitis, according to a report in the January 10th issue of the International Journal of Cancer.

"Environmental factors seem to play an important role in the pathogenesis of Barrett's esophagus, especially in Western society," Dr. Massimo Conio, of the National Cancer Research Institute, Genoa, Italy, and colleagues note. They conducted a multicenter case-control study to examine the influence of individual characteristics and lifestyle habits on the development of Barrett's esophagus.

The team compared 149 patients with Barrett's esophagus, 143 patients with esophagitis, and 308 control patients with acute, non-neoplastic, nongastroenterological conditions. The subjects completed questionnaires concerning consumption of coffee and alcohol, smoking, medical history, drug history, GERD symptoms, and socioeconomic status.

"With adjustments made for the confounding effects of geographic center, gender and age, the frequency of weekly GERD symptoms was significantly associated with both Barrett's esophagus and esophagitis (odds ratio [OR]: 5.8 and OR: 9.4, respectively, p < 0.0001), such as the presence of hiatal hernia," the authors explain.

They observed a significant association between ulcer and Barrett's esophagus (OR: 2.2, p = 0.001). Among patients with esophagitis, they found that the risk was directly related to alcohol consumption (p = 0.03).

They also noted that that patients with GERD symptoms lasting longer than 13 years were more likely to have Barrett's esophagus than esophagitis (p = 0.01).

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