Journal
AMERICAN JOURNAL OF GASTROENTEROLOGY
Volume 108, Issue 6, Pages 915-922Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/ajg.2013.72
Keywords
-
Categories
Funding
- Australian Postgraduate Award (University of Queensland)
- Cancer Council NSW STREP grant [08-04]
- NCI [R01 116845]
- NIDDK [K24-04-107]
- Houston VA HSR&D Center of Excellence [HFP90-020]
- Texas Digestive Disease Center NIH [DK58338]
Ask authors/readers for more resources
OBJECTIVES: Symptoms of gastroesophageal refl ux disease (GERD) are the primary risk factor for Barrett ' s esophagus (BE). However, the signifi cance of age at symptom onset is unknown. We examined the effects of multiple dimensions of GERD exposure on BE risk and whether these associations are modifi ed by other risk factors for BE. METHODS: Data were from a cross-sectional study of 683 Veterans Affairs patients undergoing an elective esophagogastroduodenoscopy (EGD) or a study EGD concurrently with colonoscopy from primary care clinics. We compared 236 patients with both endoscopically suspected and histologically confi rmed BE to 447 primary-care patients (primary-care controls ) without endoscopically suspected BE on their study EGD. Odds ratios (ORs) and 95 % confi dence intervals (CIs) were calculated using multivariate logistic regression. RESULTS: Age at onset <30 years of frequent (at least weekly) GERD symptoms was associated with highest risk of BE (OR = 15.1, 95 % CI 7.91-28.8), and risk increased linearly with earlier age at onset of symptoms (P-trend = 0.001). This association was independent of cumulative GERD symptom duration. People with early onset GERD symptoms who reported ever using proton pump inhibitors were at especially high risk of BE (OR = 31.1, 95 % CI 13.9-69.7). In people with frequent GERD symptoms, BE risk was almost 80 % lower among Helicobacter pylori -positive patients (OR = 2.60, 95 % CI 1.26-5.40) than those negative for H. pylori (OR = 8.24, 95 % CI 5.00-13.6). CONCLUSIONS: Risk of BE increased linearly with earlier age at onset of frequent GERD symptoms. Age at symptom onset may help practitioners decide which patients with GERD symptoms to refer for endoscopic screening for BE.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available