title: Association between Helicobacter pylori and Barrett's esophagus: a case-control study.
abstract: OBJECTIVE
  The estimated association between Helicobacter pylori and Barrett's esophagus (BE) has been heterogenous across previous studies. In this study, we aimed to examine the association between H. pylori and BE and to identify factors that may explain or modify this association.
  
  
  METHODS
  We conducted a case-control study in which we used screening colonoscopy controls recruited from primary care clinics as our primary control group in order to minimize selection bias. All participants underwent an esophagogastroduodenoscopy with gastric mapping biopsies. We used logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to estimate the association between H. pylori and BE while controlling for confounders.
  
  
  RESULTS
  We identified 218 cases and 439 controls. The overall OR for the association between H. pylori and BE after controlling for age and white race was 0.55 (95% CI: 0.35-0.84). We observed an even stronger inverse association (OR: 0.28; 95% CI: 0.15, 0.50) among participants with corpus atrophy or antisecretory drug use ≥ 1 time per week (factors thought to lower gastric acidity), and no inverse association in patients without these factors (OR: 1.32; 95% CI: 0.66, 2.63).
  
  
  CONCLUSIONS
  The association between H. pylori and a decreased risk for BE appears to occur in patients with factors that would likely lower gastric acidity (corpus atrophy or taking antisecretory drugs at least once a week).
authors.affiliation: 1] Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, Texas, USA [2] Department of Epidemiology, University of Arkansas for Medical Sciences, College of Public Health, Little Rock, Arkansas, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Fischbach
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
authors.affiliation: 1] Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA [2] VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Section of Health Services Research, Houston, Texas, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Kramer
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Diagnostic Medical Sciences & Special Therapies, University of Padova, Padova, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rugge
authors.affiliation: Department of Pathology, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Gordana
authors.initials: G
authors.lastname: Verstovsek
authors.affiliation: Surgical Pathology & Cytopathology Unit, Department of Diagnostic Medical Sciences & Special Therapies, University of Padova, Padova, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Parente
authors.affiliation: 1] Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA [2] Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA [3] VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Section of Health Services Research, Houston, Texas, USA.
authors.forename: Abeer
authors.initials: A
authors.lastname: Alsarraj
authors.affiliation: 1] Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA [2] Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA [3] VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Section of Health Services Research, Houston, Texas, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fitzgerald
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Shaib
authors.affiliation: 1] Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA [2] VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Section of Health Services Research, Houston, Texas, USA.
authors.forename: Neena S
authors.initials: NS
authors.lastname: Abraham
authors.affiliation: Primary Care, Michael E. DeBakey VA Medical Center, Department of Medicine, Houston, Texas, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Kolpachi
authors.affiliation: Primary Care, Michael E. DeBakey VA Medical Center, Department of Medicine, Houston, Texas, USA.
authors.forename: Swapna
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: Vela
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Velez
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Cole
authors.affiliation: Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Bhupinderjit
authors.initials: B
authors.lastname: Anand
authors.affiliation: 1] Michael E. DeBakey VA Medical Center, Department of Medicine, Section of Gastroenterology and Hepatology, Houston, Texas, USA [2] VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Section of Gastroenterology and Hepatology, Houston, Texas, USA.
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El Serag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000175:diagnosis / Q000382:microbiology*; D016022:Case-Control Studies; D003113:Colonoscopy; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000382:microbiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors