GERD frequency, severity predict Barrett’s oesophagus
Individuals with severe and frequent gastro-oesophageal reflux disease (GERD) are at increased risk of Barrett’s oesophagus (BE), especially in the absence of frequent proton pump inhibitor (PPI) use, a recent study has found. Family history of BE and early age of symptom onset are strong predictors of BE among people with GERD.
A total of 953 patients were interviewed (320 with BE, 316 with GERD who lacked BE and 317 population controls). Risk of BE was highest among patients with the most frequent and severe GERD symptoms (odds ratio [OR], 27.00; 95 percent CI, 14.52–50.21), nocturnal symptoms (OR, 5.40; 3.81–7.72) and family history of GERD (OR, 2.55; 1.80–3.62) or BE (OR, 10.08; 2.83–35.84) compared with controls.
At least weekly PPI use was a risk factor for BE (OR, 9.85; 6.54–14.84), but GERD symptoms were not strongly associated with the risk of BE among PPI users in the general population. Onset of GERD symptoms before 30 years of age (OR, 1.93; 1.15–3.22) and a family history of BE (OR, 3.64; 1.50–8.83) predicted BE among those with GERD vs controls.
“These findings may improve identification of patients at highest risk for BE,” the investigators said.
A case-control study was conducted within the Kaiser Permanente Northern California population. Cases were newly diagnosed with BE. The investigators contrasted cases with population controls to identify risk factors in the general population, and with GERD patients who lacked BE to identify risk factors only among patients with GERD.
“GERD is a known risk factor for oesophageal adenocarcinoma, but the ability of GERD symptom frequency and severity to predict presence of its putative precursor lesion, BE, is less well-defined in large, community-based populations,” the investigators said.