title: Risk factors for Barrett's esophagus: a case-control study.
abstract: Barrett's esophagus (BE) is an acquired disorder due to chronic gastroesophageal reflux. Environmental factors seem to play an important role in the pathogenesis of BE, especially in Western society. A multicenter case-control study was carried out between February 1995 and April 1999 in 8 Italian Departments of Gastroenterology gathered in a study group (GOSPE), in order to analyze the influence of some individual characteristics and life-style habits on the occurrence of BE. Three groups of patients were studied: 149 patients with BE, 143 patients with esophagitis (E) and 308 hospital controls (C) with acute, non-neoplastic, non-gastroenterological conditions. The diagnosis of BE was based on endoscopy and histology. E was defined by the Savary classification (grade I-III). Data collection was performed by using a questionnaire that focused on smoking, coffee and alcohol consumption, medical history, drugs history, gastroesophageal reflux disease (GERD) symptoms (heartburn, regurgitation) and socio-economic status. Multivariate analysis showed that the frequency of weekly GERD symptoms was significantly associated with both BE and E (p<0.0001), such as the presence of hiatal hernia (p< or =0.001). Ulcer was significantly associated with BE (p=0.001). Among patients with E, the risk was directly related to spirits consumption (p=0.03). Patients with GERD symptoms that lasted more than 13 years were more likely to have BE than E (p=0.01). In conclusion, results from our study point out that long-standing GERD symptoms, hiatal hernia and possibly alcohol consumption are risk factors in the development of the BE and E.
authors.affiliation: Department of Gastroenterology, National Cancer Research Institute, Largo R. Benzi, 10, 16132 Genoa, Italy. mxconio@tin.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Conio
authors.forename: Rosangela
authors.initials: R
authors.lastname: Filiberti
authors.forename: Sabrina
authors.initials: S
authors.lastname: Blanchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferraris
authors.forename: Santino
authors.initials: S
authors.lastname: Marchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Ravelli
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lapertosa
authors.forename: Gaetano
authors.initials: G
authors.lastname: Iaquinto
authors.forename: Renato
authors.initials: R
authors.lastname: Sablich
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gusmaroli
authors.forename: Hugo
authors.initials: H
authors.lastname: Aste
authors.forename: Attilio
authors.initials: A
authors.lastname: Giacosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology*; D016022:Case-Control Studies; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires