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Erosive esophagitis is a risk factor for Barrett's esophagus: a community-based endoscopic follow-up study.
Am J Gastroenterol. 2011 Nov; 106(11):1946-52.AJ

Abstract

OBJECTIVES

Symptomatic gastroesophageal reflux disease (GERD) is associated with a significantly increased risk of esophageal adenocarcinoma, but its natural history in the general population is poorly understood. Whether nonerosive reflux disease (NERD) is a risk factor for Barrett's esophagus (BE), the precursor of esophageal adenocarcinoma, is unknown. Furthermore, quantifying the risk of incident BE in those with untreated reflux esophagitis has not been possible. We aimed, in a prospective follow-up study with endoscopy, to evaluate the risk of BE in a cohort from the Swedish general population (the Kalixanda Study).

METHODS

Those with endoscopic or histological findings suggestive of GERD and randomly half of those with NERD (n=481) were invited for follow-up investigation including endoscopy and a validated symptom questionnaire 5 years after the initial study. Multinomial logistic regression was used to estimate relative risk ratios (RRRs) and 95% confidence intervals (CIs) for change in presentation of GERD.

RESULTS

Of the 405 subjects available for inclusion, endoscopy was performed in 284 (response rate 70.1%). The incidence of BE was 9.9/1,000 person-years. Of those with NERD at baseline (n=113), progression to erosive esophagitis was found in 11; 2 developed BE. Erosive esophagitis (n=90) progressed to a more severe grade in 12 and to BE in 8 cases. Erosive esophagitis at baseline was independently associated with BE at follow-up (RRR 5.2; 95% CI 1.2-22.9).

CONCLUSIONS

Compared with being free of GERD at follow-up, erosive esophagitis is a major risk factor for BE (with a fivefold increased risk) after 5 years in the general population.

Authors+Show Affiliations

Institute of Health Sciences, University of Oulu, Oulu, Finland. jukka.ronkainen@fimnet.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21946284

Citation

Ronkainen, Jukka, et al. "Erosive Esophagitis Is a Risk Factor for Barrett's Esophagus: a Community-based Endoscopic Follow-up Study." The American Journal of Gastroenterology, vol. 106, no. 11, 2011, pp. 1946-52.
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(11):1946-52.
Ronkainen, J., Talley, N. J., Storskrubb, T., Johansson, S. E., Lind, T., Vieth, M., Agréus, L., & Aro, P. (2011). Erosive esophagitis is a risk factor for Barrett's esophagus: a community-based endoscopic follow-up study. The American Journal of Gastroenterology, 106(11), 1946-52. https://doi.org/10.1038/ajg.2011.326
Ronkainen J, et al. Erosive Esophagitis Is a Risk Factor for Barrett's Esophagus: a Community-based Endoscopic Follow-up Study. Am J Gastroenterol. 2011;106(11):1946-52. PubMed PMID: 21946284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Erosive esophagitis is a risk factor for Barrett's esophagus: a community-based endoscopic follow-up study. AU - Ronkainen,Jukka, AU - Talley,Nicholas J, AU - Storskrubb,Tom, AU - Johansson,Sven-Erik, AU - Lind,Tore, AU - Vieth,Michael, AU - Agréus,Lars, AU - Aro,Pertti, Y1 - 2011/09/27/ PY - 2011/9/28/entrez PY - 2011/9/29/pubmed PY - 2012/1/4/medline SP - 1946 EP - 52 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 106 IS - 11 N2 - OBJECTIVES: Symptomatic gastroesophageal reflux disease (GERD) is associated with a significantly increased risk of esophageal adenocarcinoma, but its natural history in the general population is poorly understood. Whether nonerosive reflux disease (NERD) is a risk factor for Barrett's esophagus (BE), the precursor of esophageal adenocarcinoma, is unknown. Furthermore, quantifying the risk of incident BE in those with untreated reflux esophagitis has not been possible. We aimed, in a prospective follow-up study with endoscopy, to evaluate the risk of BE in a cohort from the Swedish general population (the Kalixanda Study). METHODS: Those with endoscopic or histological findings suggestive of GERD and randomly half of those with NERD (n=481) were invited for follow-up investigation including endoscopy and a validated symptom questionnaire 5 years after the initial study. Multinomial logistic regression was used to estimate relative risk ratios (RRRs) and 95% confidence intervals (CIs) for change in presentation of GERD. RESULTS: Of the 405 subjects available for inclusion, endoscopy was performed in 284 (response rate 70.1%). The incidence of BE was 9.9/1,000 person-years. Of those with NERD at baseline (n=113), progression to erosive esophagitis was found in 11; 2 developed BE. Erosive esophagitis (n=90) progressed to a more severe grade in 12 and to BE in 8 cases. Erosive esophagitis at baseline was independently associated with BE at follow-up (RRR 5.2; 95% CI 1.2-22.9). CONCLUSIONS: Compared with being free of GERD at follow-up, erosive esophagitis is a major risk factor for BE (with a fivefold increased risk) after 5 years in the general population. SN - 1572-0241 UR - https://www.unboundmedicine.com/medline/citation/21946284/Erosive_esophagitis_is_a_risk_factor_for_Barrett's_esophagus:_a_community_based_endoscopic_follow_up_study_ L2 - http://Insights.ovid.com/pubmed?pmid=21946284 DB - PRIME DP - Unbound Medicine ER -