Risks of substance uses, alcohol flush response, Helicobacter pylori infection and upper digestive tract diseases—An endoscopy cross‐sectional study

Abstract

This study examines the effects of environmental hazards, including tobacco, alcohol/alcohol flush response, areca nut, and Helicobacter pylori (H pylori) infection on upper digestive diseases. This is a multi‐hospital‐based endoscopy‐survey cross‐sectional study. Subjects were received upper endoscopies in outpatient clinics at four hospitals in Taiwan between 2008 and 2013. Biopsy‐based methods or urea breath test were used confirm the status of H pylori infection. In total, 8135 subjects were analyzed. Higher cumulative amounts of alcohol consumption were at higher risk of Barrett's esophagus and esophageal squamous cell carcinoma (ESCC), higher cumulative amounts of tobacco consumption were at higher risk of peptic ulcer, and higher cumulative amounts of areca nut consumption were at higher risk of duodenitis. Alcohol flush response was significant risk for reflux esophagitis and Barrett's esophagus (adjusted odds ratio [aOR] = 1.18 and 1.32, 95% confidence interval [CI] = 1.07‐1.31 and 1.06‐1.65, respectively). H pylori infection was inversely associated with ESCC risk (aOR = 0.20, 95% CI = 0.10‐0.40). In addition, H pylori infection was consistently and significantly risk factors for gastrointestinal diseases, including peptic ulcer, gastric adenocarcinoma, and duodenitis (aOR = 5.51, 1.84, and 2.10, 95% CI = 4.85‐6.26, 1.03‐3.26, and 1.71‐2.56, respectively). Besides the cumulative risk of alcohol, tobacco, and areca nut for Barrett's esophagus, ESCC, and peptic ulcer, respectively, presence of facial flushing was the significant risk for reflux esophagitis and Barrett's esophagus. H pylori infection was positively associated with peptic ulcer, gastric adenocarcinoma, and duodenitis, but inversely associated with ESCC.

Helicobacter pylori infection is associated with reduced risk of Barrett’s esophagus: a meta-analysis and systematic review

“…In addition, we divided the studies according to whether Hp could be confirmed as a present infection, into the present infected subgroup ( Hp positive with rapid urease test, urea breath test, histology, or culture), infection history subgroup ( Hp positive with serological detection, treatment history, or infection history), and not clear subgroup. In the present infected group with 24 studies, the prevalence of Hp infection in BE was significantly lower than that in controls (OR = 0.69; 95% CI, 0.54–0.89; P = 0.005; I 2 = 92%) [ 11 , 13 , 36 , 37 , 39 – 44 , 46 48 , 49 , 51 , 53 , 55 , 56 , 60 – 63 , 65 – 67 ], while the negative correlation disappeared again in the infection history subgroup (OR = 0.88; 95% CI, 0.43–1.78; P = 0.73; I 2 = 95%) (Fig. 5 ) [ 12 , 35 , 38 , 54 , 57 ].…”

“…Subgroup analysis was conducted according to differences in definition of control group. Fourteen studies regarded patients with GERD as control group [ 37 , 43 , 49 , 52 , 54 , 55 , 58 – 60 62 63 , 64 66 , 67 ]. There was no significant difference in the prevalence of Hp infection between BE and GERD controls (OR = 0.99; 95% CI, 0.82–1.20; P = 0.91; I 2 = 33%).…”

“…When BE was defined as intestinal metaplasia (IM) in 26 studies, we found an increased negative correlation between Hp prevalence and BE (OR = 0.64; 95% CI, 0.51–0.80; P = 0.0001; I 2 = 90%) [ 11 , 12 , 13 , 36 , 38 , 40 , 42 – 45 , 50 , 52 – 58 , 60 – 67 ]. However, the negative correlation disappeared (OR = 0.76; 95% CI, 0.51–1.14; P = 0.18; I 2 = 92%) in the other subgroups, which diagnosed BE with columnar metaplasia (CM), endoscopic presentation, no clear definition, and gastric epithelium [ 35 , 37 , 39 , 41 , 46 – 49 , 51 , 59 ]. In addition, we divided the studies according to whether Hp could be confirmed as a present infection, into the present infected subgroup ( Hp positive with rapid urease test, urea breath test, histology, or culture), infection history subgroup ( Hp positive with serological detection, treatment history, or infection history), and not clear subgroup.…”

Substance use and esophageal neuroendocrine neoplasm: A case–control study

“…This cohort collected information of substance use and history of diseases by standardized questionnaires and a trained interviewer. Patients with history of upper gastrointestinal tract cancer or upper gastrointestinal tract surgery were excluded 13,14 . The gender composition was balanced (50.8% female and 49.2% male) and most participants were 50–69 years of age (48.4%), with (71.2%) having no history of substance use and the percentages of history of cigarette, alcohol and betel quid use were 24.8%, 14.8% and 7.9%, respectively.…”

Principais fatores de risco e aspectos gerais da doença ulcerosa péptica na atualidade

“…O consumo indiscriminado de bebidas alcoólicas, por sua vez, aumenta a predisposição na formação de úlceras gástricas ao estimular a maior liberação de gastrina e consequentemente aumentando a secreção de ácido gástrico (SEYOUM et al, 2020). Chuang et al (2019) constataram que usuários de bebidas alcoólicas apresentaram um risco duas vezes maior de adquirir úlcera gástrica e 1,29 vezes o risco de desenvolverem úlcera duodenal, comparado aos não usuários.…”