Symptoms of gastroesophageal reflux disease (GERD) are the primary risk factor for Barrett's esophagus.
However, the significance of age at symptom onset is unknown.
Dr Aaron Thrift and colleagues from Australia examined the effects of multiple dimensions of gastroesophageal reflux disease exposure on Barrett's esophagus risk and whether these associations are modified by other risk factors for Barrett's esophagus.
The team reported that data were from a cross-sectional study of 683 Veterans Affairs patients undergoing an elective esophagogastroduodenoscopy or a study elective esophagogastroduodenoscopy concurrently with colonoscopy from primary care clinics.
The research team compared 236 patients with both endoscopically suspected and histologically confirmed Barrett's esophagus to 447 primary-care patients without endoscopically suspected Barrett's esophagus on their study elective esophagogastroduodenoscopy.
Age at onset 30 years of frequent gastroesophageal reflux disease symptoms was associated with highest risk of Barrett's esophagus, and risk increased linearly with earlier age at onset of symptoms.
|Barrett's risk was almost 80% lower among H. pylori-positive patients |
|The American Journal of Gastroenterology|
This association was independent of cumulative gastroesophageal reflux disease symptom duration.
The doctors found that people with early onset gastroesophageal reflux disease symptoms who reported ever using proton pump inhibitors were at especially high risk of Barrett's esophagus.
In people with frequent gastroesophageal reflux disease symptoms, Barrett's esophagus risk was almost 80% lower among Helicobacter pylori-positive patients than those negative for H. pylori.
Dr Thrift's team concluded, "Risk of Barrett's esophagus increased linearly with earlier age at onset of frequent gastroesophageal reflux disease symptoms."
"Age at symptom onset may help practitioners decide which patients with gastroesophageal reflux disease symptoms to refer for endoscopic screening for Barrett's esophagus."