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Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects

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Abstract

Background

Predictors of erosive esophagitis (EE) and Barrett’s esophagus (BE) and the influence of number of risk factors in the community are not well defined.

Methods

Rates of BE and EE among community residents identified in a randomized screening trial were defined. The risk of EE and BE associated with single and multiple risk factors (gender, age, GERD, Caucasian ethnicity, ever tobacco use, excess alcohol use, family history of BE or EAC, and central obesity) was analyzed.

Results

Sixty-eight (33 %) of 205 subjects had EE and/or BE. BE prevalence was 7.8 % with dysplasia present in 1.5 %. Rates were comparable between subjects with and without GERD. Male sex and central obesity were independent risk factors. The odds of EE or BE were 3.7 times higher in subjects with three or four risk factors and 5.7 times higher in subjects with five or more risk factors compared with those with two or less factors.

Conclusions

EE and BE are prevalent in the community regardless of the presence of GERD. Risk appeared to be additive, increasing substantially with three or more risk factors.

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References

  1. Pohl H, Sirovich B, Welch HG. Esophageal adenocarcinoma incidence: are we reaching the peak? Cancer Epidemiol Biomark Prev. 2010;19:1468–1470.

    Article  Google Scholar 

  2. Das A, Singh V, Fleischer DE, Sharma VK. A comparison of endoscopic treatment and surgery in early esophageal cancer: an analysis of surveillance epidemiology and end results data. Am J Gastroenterol. 2008;103:1340–1345.

    Article  PubMed  Google Scholar 

  3. Fitzgerald RC, di Pietro M, Ragunath K, et al. British society of gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63:7–42.

    Article  PubMed  Google Scholar 

  4. Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2016;111:30–50 (quiz 51).

  5. Whiteman DC, Sadeghi S, Pandeya N, et al. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57:173–180.

    Article  CAS  PubMed  Google Scholar 

  6. Taylor JB, Rubenstein JH. Meta-analyses of the effect of symptoms of gastroesophageal reflux on the risk of Barrett’s esophagus. Am J Gastroenterol. 2010;105:1729–1737 (quiz 1738).

  7. Rubenstein JH, Scheiman JM, Sadeghi S, Whiteman D, Inadomi JM. Esophageal adenocarcinoma incidence in individuals with gastroesophageal reflux: synthesis and estimates from population studies. Am J Gastroenterol. 2011;106:254–260.

    Article  PubMed  Google Scholar 

  8. Ronkainen J, Aro P, Storskrubb T, Johansson SE, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–1831.

    Article  PubMed  Google Scholar 

  9. Ward EM, Wolfsen HC, Achem SR, et al. Barrett’s esophagus is common in older men and women undergoing screening colonoscopy regardless of reflux symptoms. Am J Gastroenterol. 2006;101:12–17.

    Article  PubMed  Google Scholar 

  10. Zagari RM, Fuccio L, Wallander MA, et al. Gastro-oesophageal reflux symptoms, oesophagitis and Barrett’s oesophagus in the general population: the Loiano-Monghidoro study. Gut. 2008;57:1354–1359.

    Article  CAS  PubMed  Google Scholar 

  11. Singh S, Sharma AN, Murad MH, et al. Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11:1399–1412.

    Article  PubMed  Google Scholar 

  12. Iyer PG, Borah BJ, Heien HC, Das A, Cooper GS, Chak A. Association of Barrett’s esophagus with type II diabetes mellitus: results from a large population-based case–control study. Clin Gastroenterol Hepatol. 2013;11:1108–1114.

    Article  PubMed  Google Scholar 

  13. Rubenstein JH, Morgenstern H, Appelman H, et al. Prediction of Barrett’s esophagus among men. Am J Gastroenterol. 2013;108:353–362.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Thrift AP, Kendall BJ, Pandeya N, Whiteman DC. A model to determine absolute risk for esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2013;11:138–144.

    Article  PubMed  Google Scholar 

  15. Sami SS, Dunagan KT, Johnson ML, et al. A randomized comparative effectiveness trial of novel endoscopic techniques and approaches for Barrett’s esophagus screening in the community. Am J Gastroenterol. 2015;110:148–158.

    Article  PubMed  Google Scholar 

  16. Locke GR, Talley NJ, Weaver AL, Zinsmeister AR. A new questionnaire for gastroesophageal reflux disease. Mayo Clin Proc. 1994;69:539–547.

    Article  CAS  PubMed  Google Scholar 

  17. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the prague C & M criteria. Gastroenterology. 2006;131:1392–1399.

    Article  PubMed  Google Scholar 

  18. Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111:85–92.

    Article  CAS  PubMed  Google Scholar 

  19. Ronkainen J, Talley NJ, Storskrubb T, et al. Erosive esophagitis is a risk factor for Barrett’s esophagus: a community-based endoscopic follow-up study. Am J Gastroenterol. 2011;106:1946–1952.

    Article  PubMed  Google Scholar 

  20. Hanna S, Rastogi A, Weston AP, et al. Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis. Am J Gastroenterol. 2006;101:1416–1420.

    Article  PubMed  Google Scholar 

  21. Modiano N, Gerson LB. Risk factors for the detection of Barrett’s esophagus in patients with erosive esophagitis. Gastrointest Endosc. 2009;69:1014–1020.

    Article  PubMed  Google Scholar 

  22. Nishida C, Ko GT, Kumanyika S. Body fat distribution and noncommunicable diseases in populations: overview of the 2008 who expert consultation on waist circumference and waist–hip ratio. Eur J Clin Nutr. 2010;64:2–5.

    Article  CAS  PubMed  Google Scholar 

  23. Rex DK, Cummings OW, Shaw M, et al. Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn. Gastroenterology. 2003;125:1670–1677.

    Article  PubMed  Google Scholar 

  24. Gerson LB, Banerjee S. Screening for Barrett’s esophagus in asymptomatic women. Gastrointest Endosc. 2009;70:867–873.

    Article  PubMed  Google Scholar 

  25. Katzka DA, Castell DO. Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett’s esophagus. Am J Gastroenterol. 1994;89:989–991.

    CAS  PubMed  Google Scholar 

  26. Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101:2619–2628.

    Article  PubMed  Google Scholar 

  27. Bennett C, Moayyedi P, Corley DA, et al. Bob cat: a large-scale review and Delphi consensus for management of Barrett’s esophagus with no dysplasia, indefinite for, or low-grade dysplasia. Am J Gastroenterol. 2015;110:662–682 (quiz 683).

  28. Benaglia T, Sharples LD, Fitzgerald RC, Lyratzopoulos G. Health benefits and cost effectiveness of endoscopic and nonendoscopic cytosponge screening for Barrett’s esophagus. Gastroenterology. 2013;144:62–73.

    Article  PubMed  Google Scholar 

  29. Peery AF, Hoppo T, Garman KS, et al. Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video). Gastrointest Endosc. 2012;75:945–953.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Saeian K, Staff DM, Vasilopoulos S, Townsend WF, et al. Unsedated transnasal endoscopy accurately detects Barrett’s metaplasia and dysplasia. Gastrointest Endosc. 2002;56:472–478.

    Article  PubMed  Google Scholar 

  31. Sami SS, Subramanian V, Fernández-Sordo JO, et al. Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract: systematic review and meta-analysis. Gastrointest Endosc. 2015;82:782–792.

    Google Scholar 

  32. Shariff MK, Varghese S, O’Donovan M, et al. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett’s esophagus. Endoscopy. 2016;48:110–116.

    PubMed  Google Scholar 

  33. Rubenstein JH, Thrift AP. Risk factors and populations at risk: selection of patients for screening for Barrett’s oesophagus. Best Pract Res Clin Gastroenterol. 2015;29:41–50.

    Article  PubMed  Google Scholar 

  34. Thrift AP, Garcia JM, El-Serag HB. A multibiomarker risk score helps predict risk for Barrett’s esophagus. Clin Gastroenterol Hepatol. 2014;12:1267–1271.

    Article  PubMed  Google Scholar 

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Financial Support

This study was funded in part by NIH Grant (RC4DK090413). This publication was also made possible by CTSA Grant No. UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Authors’ Contributions

NRC contributed to analysis and interpretation of data and drafted the manuscript. MLJ contributed to the acquisition of data and analysis. CDS contributed to acquisition of data and data analysis. FTE contributed to acquisition of data and data analysis. L-MW contributed to acquisition of data and critical revision of the manuscript for important intellectual content. KKW contributed to critical revision of the manuscript for important intellectual content. DAK contributed to acquisition of data and critical revision of the manuscript for important intellectual content. PGI contributed to study concept and design, acquisition of data, analysis, and interpretation of data, and critical revision of the manuscript for important intellectual content, obtained funding, and was involved in study supervision. All authors approved final version of this article, including authorship list.

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Authors and Affiliations

  1. Division of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Nicholas R. Crews

  2. Barrett’s Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    Michele L. Johnson, Louis-Michel Wongkeesong, Kenneth K. Wang, David A. Katzka & Prasad G. Iyer

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Cathy D. Schleck & Felicity T. Enders

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  1. Nicholas R. Crews
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Correspondence to Prasad G. Iyer.

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Appendix: Symptomatic GER Questions from GERQ

Appendix: Symptomatic GER Questions from GERQ

  1. 1.

    How many times have you had a burning pain or discomfort behind the breast bone in your chest in the last year? (Please do not count pain in your stomach or pain from heart trouble.)

  2. 2.

    How many times have you had acid regurgitation in the last year?

  3. 3.

    How many times have you taken antacids (like amphojel, AlternaGEL, gaviscon, maalox, mylanta, riopan, rolaids, or tums) in the last year?

  4. 4.

    Have you taken any of the following over-the-counter medications in the last year: axid AR (nizatidine), pepcid AC (famotidine), tagamet HB (cimetidine), or zantac (ranitidine)? If yes, how many times?

  5. 5.

    Have you taken any of the following medications in the last year with a doctor’s prescription: prevacid (lansoprazole), prilosec (omeprazole), propulsid (cisapride), protonix (pantoprazole), and aciphex (rabeprazole)? If yes, how many times?

** Each question had five possible answers: less than once a week, about once a month, about once a week, several times a week, and daily.

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Crews, N.R., Johnson, M.L., Schleck, C.D. et al. Prevalence and Predictors of Gastroesophageal Reflux Complications in Community Subjects. Dig Dis Sci 61, 3221–3228 (2016). https://doi.org/10.1007/s10620-016-4266-3

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  • DOI: https://doi.org/10.1007/s10620-016-4266-3

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