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Barrett's esophagus and medications that relax the lower esophageal sphincter.
Am J Gastroenterol. 2006 May; 101(5):937-44.AJ

Abstract

OBJECTIVES

Medications that may increase gastroesophageal reflux could be risk factors for esophageal adenocarcinoma; however, epidemiologic studies present conflicting results. We evaluated patients with a high-risk condition, Barrett's esophagus, to identify risk factors that may act early in the carcinogenic process.

METHODS

We conducted a nested case-control study within a large integrated health-services organization. Electronic databases were used to identify incident diagnoses of Barrett's esophagus (cases); two controls were matched to each case. Electronic databases provided information on the use of medications that may induce reflux (nitrates, calcium channel blockers, xanthines, benzodiazepines, and beta agonists) and potential confounders. A supplemental mailed questionnaire evaluated additional potential confounders.

RESULTS

We identified 421 cases and selected 842 controls. The association between any medication use and a Barrett's esophagus diagnosis was modified by age; an increased risk was observed only among subjects <70 yr of age (adjusted odds ratio [OR] = 2.6; 95% confidence interval [CI] 1.5-4.6). A Barrett's esophagus diagnosis was associated with asthma medication use (OR 5.8; 95% CI 2.2, 14.9), but not with the other medications studied. Subgroup analyses suggested that medication use was not independently associated with reflux symptoms and that adjustment for asthma symptoms substantially reduced the association between medication use and a Barrett's esophagus diagnosis.

CONCLUSION

The use of medications that may induce reflux was associated with a Barrett's esophagus diagnosis among younger persons. This association was only observed with asthma medications; the analyses suggested the possibility of confounding by indication, whereby reflux may cause both asthma and Barrett's esophagus.

Authors+Show Affiliations

Northern California Kaiser Permanente Division of Research, Oakland 94612, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16573773

Citation

Corley, Douglas A., et al. "Barrett's Esophagus and Medications That Relax the Lower Esophageal Sphincter." The American Journal of Gastroenterology, vol. 101, no. 5, 2006, pp. 937-44.
Corley DA, Levin TR, Habel LA, et al. Barrett's esophagus and medications that relax the lower esophageal sphincter. Am J Gastroenterol. 2006;101(5):937-44.
Corley, D. A., Levin, T. R., Habel, L. A., & Buffler, P. A. (2006). Barrett's esophagus and medications that relax the lower esophageal sphincter. The American Journal of Gastroenterology, 101(5), 937-44.
Corley DA, et al. Barrett's Esophagus and Medications That Relax the Lower Esophageal Sphincter. Am J Gastroenterol. 2006;101(5):937-44. PubMed PMID: 16573773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Barrett's esophagus and medications that relax the lower esophageal sphincter. AU - Corley,Douglas A, AU - Levin,Theodore R, AU - Habel,Laurel A, AU - Buffler,Patricia A, PY - 2006/4/1/pubmed PY - 2006/6/7/medline PY - 2006/4/1/entrez SP - 937 EP - 44 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 101 IS - 5 N2 - OBJECTIVES: Medications that may increase gastroesophageal reflux could be risk factors for esophageal adenocarcinoma; however, epidemiologic studies present conflicting results. We evaluated patients with a high-risk condition, Barrett's esophagus, to identify risk factors that may act early in the carcinogenic process. METHODS: We conducted a nested case-control study within a large integrated health-services organization. Electronic databases were used to identify incident diagnoses of Barrett's esophagus (cases); two controls were matched to each case. Electronic databases provided information on the use of medications that may induce reflux (nitrates, calcium channel blockers, xanthines, benzodiazepines, and beta agonists) and potential confounders. A supplemental mailed questionnaire evaluated additional potential confounders. RESULTS: We identified 421 cases and selected 842 controls. The association between any medication use and a Barrett's esophagus diagnosis was modified by age; an increased risk was observed only among subjects <70 yr of age (adjusted odds ratio [OR] = 2.6; 95% confidence interval [CI] 1.5-4.6). A Barrett's esophagus diagnosis was associated with asthma medication use (OR 5.8; 95% CI 2.2, 14.9), but not with the other medications studied. Subgroup analyses suggested that medication use was not independently associated with reflux symptoms and that adjustment for asthma symptoms substantially reduced the association between medication use and a Barrett's esophagus diagnosis. CONCLUSION: The use of medications that may induce reflux was associated with a Barrett's esophagus diagnosis among younger persons. This association was only observed with asthma medications; the analyses suggested the possibility of confounding by indication, whereby reflux may cause both asthma and Barrett's esophagus. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/16573773/Barrett's_esophagus_and_medications_that_relax_the_lower_esophageal_sphincter_ L2 - http://Insights.ovid.com/pubmed?pmid=16573773 DB - PRIME DP - Unbound Medicine ER -