Risk Factors for Barrett's Oesophagus

Abstract

Background: Barrett's oesophagus (BO) is a premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Globally, the incidence of OAC is rising. Furthermore, the prognosis regarding the morbidity and mortality of OAC is bleak, with an estimated 5-year survival of 10-15%. Hence, detection of the premalignant phase is paramount. Endoscopy and biopsy sampling is the mainstay of diagnosis. Patients may present with symptoms of gastro-oesophageal reflux disease (GORD) or be completely asymptomatic. Therefore, symptomatology alone is a poor indicator of this condition. Summary: This review highlights the current risk factors associated with the development of BO. Key Message: Primary risk factors for BO include male gender, increased age, a family history of the disease, long-standing GORD, smoking, obesity (specifically determined by the waist-to-hip ratio as opposed to BMI), and Caucasian race. Alcohol consumption and Helicobacter pylori are not associated with the condition. Practical Implications: By ensuring an appropriate understanding of the risk factors, clinicians can discern at-risk patients for endoscopic diagnosis and surveillance.

Risk factors of erosive esophagitis and barrett’s esophagus in patients with reflux symptoms

“…The duration of symptoms before endoscopy was significant for patients with EE but not for patients with BE. The study by Sharma N. et al ( 28 ) showed an increased risk of BE with in creasing duration of GERD symptoms. This may be explained by the fact that the majority of our patients had GERD for less than 5 years which may not be sufficient to cause Barrette mucosa (mean of duration of symptoms : 2.53 versus 2.84 years, p=0.74).…”

High prevalence of esophagitis in patients with severe ineffective esophageal motility: need for a new diagnostic cutoff

“…To examine the association with Barrett’s esophagus, we used binary logistic regression. All the regression models were adjusted for potentially confounding characteristics, including male sex, older age, higher BMI, lower LES resting pressures [ 19 - 23 ], positive H. pylori state [ 19 , 24 ], and abnormal multiple rapid swallows [ 25 ]. Data were cleaned and analyzed using the Python programming language version 3.8.6.…”

Key Considerations From a Health Authority Perspective When Proton Pump Inhibitors Are Used to Treat Gastroesophageal Reflux Disease (GERD) and Their Implications

“…Barrett’s esophagus is also a complication with GERD following on from NERD and dysphagia, with some studies suggesting erosive esophagitis as a major risk factor for Barrett’s esophagus, with up to a fivefold increased risk [ 9 , 34 , 35 ]. The risk of Barrett’s esophagus increases with the length of time of untreated GERD [ 36 ] and is typically a precursor to esophageal adenocarcinoma [ 3 , 35 , 37 ]. Eusebi et al recently estimated the pooled prevalence of patients with confirmed Barrett’s esophagus in those with GERD at 7.0%, higher among those who drank alcohol [ 17 ].…”