Risk factors for Barrettʼs esophagus

Rubenstein, Joel H.

doi:10.1097/mog.0000000000000084

Cited by 24 publications

(13 citation statements)

References 32 publications

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“…19 A systematic review of population-based studies found that a slight majority of patients with EAC deny any substantial prior symptoms of GERD. 20 It is possible that chronic reflux of gastric contents could promote EAC without causing substantial symptoms before patients present with cancer.…”

Section: Epidemiologymentioning

confidence: 99%

Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

2015

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Esophageal adenocarcinoma (EAC) is rapidly increasing in incidence in Western cultures. Barrett’s esophagus (BE) is the presumed precursor lesion for this cancer. Several other risk factors for this cancer have been described, including chronic heartburn, tobacco use, Caucasian race, and obesity. Despite these known associations, most patients with EAC present with symptoms of dysphagia from late-stage tumors—only a small minority of patients are identified in screening and surveillance programs. Diagnostic analysis of EAC usually commences with upper endoscopy, followed by cross-sectional imaging. Endoscopic ultrasound is useful to assess local extent of disease as well as the involvement regional lymph nodes. T1a EAC may be treated endoscopically; some patients with T1b disease might also benefit from endoscopic therapy. Locally advanced disease is generally managed with esophagectomy, often accompanied by neoadjuvant chemoradiotherapy or chemotherapy. The prognosis is based on tumor stage: patients with T1a tumors have an excellent prognoses, whereas few patients with advanced disease have longterm survival.

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Section: Epidemiologymentioning

confidence: 99%

Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

2015

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“…Important risk factors for BE include gastroesophageal reflux disease (GERD) symptoms, abdominal obesity, tobacco use, and male sex. 13 However, it remains unclear whether alcohol consumption is truly associated with the present of BE, and whether patients’ drinking history could increase the risk stratification for BE. Previous studies have showed a weak association between alcohol drinking and EAC.…”

Section: Introductionmentioning

confidence: 99%

Association Between Alcohol Consumption and the Risk of Barrett's Esophagus

et al. 2015

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“…These factors are: male gender, Caucasian and/or Hispanic origins, being aged fifty or over, abdominal obesity, hiatus hernia and cigarette smoking. 6 On the contrary, Helicobacter pylori infection could be a potential protective factor. 7 Aside from this data, esophageal motor disorders, especially ineffective motility, have also been suspected to be risk factors for BE in patients with GERD.…”

Section: Introductionmentioning

confidence: 99%

Esophageal Motor Disorders Are a Strong and Independant Associated Factor of Barrett's Esophagus

Bazin

Benezech

Alessandrini

et al. 2018

J Neurogastroenterol Motil

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Background/AimsEsophageal motor disorder (EMD) has been shown to be associated with gastroesophageal reflux disease (GERD). However, the association of EMD with a Barrett’s esophagus (BE) is controversial. Our objective was to evaluate whether the presence of EMD was an independent factor associated with BE.MethodsA retrospective case-control study was conducted in GERD patients who all had oeso-gastroduodenal endoscopy and high-resolution esophageal manometry. The clinical data collected was known or potential risk factors for BE: male gender, smoking and alcohol consumption, age, body mass index, presence of hiatal hernia, frequency, and age of GERD. EMD were classified according to the Chicago classification into: ineffective motor syndrome, fragmented peristalsis and absence of peristalsis, lower esophageal sphincter hypotonia.ResultsTwo hundred and one patients (101 in the GERD + BE group and 100 in the GERD without BE) were included. In univariate analysis, male gender, alcohol consumption, presence of hiatal hernia, and EMD appeared to be associated with the presence of BE. In a multivariate analysis, 3 independent factors were identified: the presence of EMD (odds ratio [OR], 3.99; 95% confidence interval [CI], 1.71–9.28; P = 0.001), the presence of hiatal hernia (OR, 5.60; 95% CI, 2.45–12.76; P < 0.001), Helicobacter pylori infection (OR, 0.08; 95% CI, 0.01–0.84; P = 0.035).ConclusionsThe presence of EMD (particularly ineffective motor syndrome and lower esophageal sphincter hypotonia) is a strong independent associated factor of BE. Searching systematically for an EMD in patients suffering from GERD could be a new strategy to organize the endoscopic follow-up.

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Risk factors for Barrettʼs esophagus

Abstract: The developing understanding of risk factors for Barrett's esophagus is shifting the clinical guidelines to a nuanced approach incorporating multiple risk factors to select patients for screening for Barrett's esophagus.

Cited by 24 publications

References 32 publications

Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma

Association Between Alcohol Consumption and the Risk of Barrett's Esophagus

Esophageal Motor Disorders Are a Strong and Independant Associated Factor of Barrett's Esophagus

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