Alcohol consumption pattern and risk of Barrett’s oesophagus and erosive oesophagitis: an Italian case–control study

Abstract

Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.

Analysis of Barrett’s Esophagus and Its Risk Factors: A Cross-Sectional Study of 10,122 Subjects at a Japanese Health Examination Center

“…In contrast to esophageal squamous cell carcinoma, alcohol consumption has not been considered associated with EAC and BE [ 52 ]. Some studies report that drinking small amounts of alcohol was a protective factor against BE, while others reported the opposite [ 15 , 53 , 54 , 55 ]. In our study, social drinking was associated with a lower risk of BE than no drinking and current drinking in both univariate and multiple logistic regression analyses.…”

Dietary and metabolic factors contributing to Barrett’s esophagus: a univariate and multivariate Mendelian randomization study

“…The copyright holder for this preprint this version posted March 25, 2023. ; https://doi.org/10.1101/2023.03.24.23287678 doi: medRxiv preprint different from other alcoholic beverages in that moderate consumption of wine might provide a protective effect 45 , while the current MR study did not subdivide the types of alcohol consumed, which might be related to the uncorrelated results. For tea intake, epidemiological studies are likewise biased by confounding factors.…”

“…In respect to alcohol drinking and tea intake, most previous studies suggested that there was no association between alcohol or tea drinking and BE 10,12 , which was consistent with the results of the current MR study. However, a few studies have indicated that both wine drinking and tea intake could reduce the risk of BE 8,45 . The possible explanations for the inconsistent results of these observational and the current MR study are as follows: for alcohol drinking, on the one hand, the epidemiological studies may be biased by confounding factors, such as different lifestyles and habits between drinkers and non-drinkers.…”

Alcohol drinking inhibits NOTCH–PAX9 signaling in esophageal squamous epithelial cells

“…The concentration of ethanol may be an important factor in ethanol's biological effects. For example, liquor/spirit consumption was associated with higher risks of GERD and Barrett's esophagus, in which NOTCH was suppressed, whereas beer/wine consumption at low doses seemed to have the opposite effect [52]. Ethanol's effects on molecular pathways also depend on the context.…”