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A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men.
PLoS One 2016; 11(11):e0165278Plos

Abstract

BACKGROUND AND AIMS

Data regarding smoking and alcohol consumption and risk of gastrointestinal bleeding (GIB) are sparse and conflicting. We assessed the risk of major GIB associated with smoking and alcohol consumption in a large, prospective cohort.

METHODS

We prospectively studied 48,000 men in the Health Professional follow-up Study (HPFS) who were aged 40-75 years at baseline in 1986. We identified men with major GIB requiring hospitalization and/or blood transfusion via biennial questionnaires and chart review.

RESULTS

We documented 305 episodes of major GIB during 26 years of follow-up. Men who consumed >30 g/day of alcohol had a multivariable relative risk (RR) of 1.43 (95% confidence interval (CI), 0.88-2.35; P for trend 0.006) for major GIB when compared with nondrinkers. Alcohol consumption appeared to be primarily related to upper GIB (multivariable RR for >30 g/day vs. nondrinkers was 1.35; 95% CI, 0.66-2.77; P for trend 0.02). Men who consumed ≥ 5 drinks/week vs. < 1 drink/month of liquor had a multivariable RR of 1.72 (95% CI, 1.26-2.35, P for trend <0.001). Wine and beer were not significantly associated with major GIB. The risk of GIB associated with NSAIDs/aspirin use increased with greater alcohol consumption (multivariable RR 1.37; 95% CI, 0.85-2.19 for 1-14g/day of alcohol, RR 1.75; 95% CI, 1.07-2.88 for ≥ 15g/day compared to nondrinkers). Smoking was not significantly associated with GIB.

CONCLUSIONS

Alcohol consumption, but not smoking, was associated with an increased risk of major GIB. Associations were most notable for upper GIB associated with liquor intake. Alcohol appeared to potentiate the risk of NSAID-associated GIB.

Authors+Show Affiliations

Department of Medicine, Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington, United States of America.Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America. Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27824864

Citation

Strate, Lisa L., et al. "A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men." PloS One, vol. 11, no. 11, 2016, pp. e0165278.
Strate LL, Singh P, Boylan MR, et al. A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. PLoS ONE. 2016;11(11):e0165278.
Strate, L. L., Singh, P., Boylan, M. R., Piawah, S., Cao, Y., & Chan, A. T. (2016). A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. PloS One, 11(11), pp. e0165278. doi:10.1371/journal.pone.0165278.
Strate LL, et al. A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. PLoS ONE. 2016;11(11):e0165278. PubMed PMID: 27824864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Prospective Study of Alcohol Consumption and Smoking and the Risk of Major Gastrointestinal Bleeding in Men. AU - Strate,Lisa L, AU - Singh,Prashant, AU - Boylan,Matthew R, AU - Piawah,Sorbarikor, AU - Cao,Yin, AU - Chan,Andrew T, Y1 - 2016/11/08/ PY - 2016/06/09/received PY - 2016/10/10/accepted PY - 2016/11/9/entrez PY - 2016/11/9/pubmed PY - 2017/6/28/medline SP - e0165278 EP - e0165278 JF - PloS one JO - PLoS ONE VL - 11 IS - 11 N2 - BACKGROUND AND AIMS: Data regarding smoking and alcohol consumption and risk of gastrointestinal bleeding (GIB) are sparse and conflicting. We assessed the risk of major GIB associated with smoking and alcohol consumption in a large, prospective cohort. METHODS: We prospectively studied 48,000 men in the Health Professional follow-up Study (HPFS) who were aged 40-75 years at baseline in 1986. We identified men with major GIB requiring hospitalization and/or blood transfusion via biennial questionnaires and chart review. RESULTS: We documented 305 episodes of major GIB during 26 years of follow-up. Men who consumed >30 g/day of alcohol had a multivariable relative risk (RR) of 1.43 (95% confidence interval (CI), 0.88-2.35; P for trend 0.006) for major GIB when compared with nondrinkers. Alcohol consumption appeared to be primarily related to upper GIB (multivariable RR for >30 g/day vs. nondrinkers was 1.35; 95% CI, 0.66-2.77; P for trend 0.02). Men who consumed ≥ 5 drinks/week vs. < 1 drink/month of liquor had a multivariable RR of 1.72 (95% CI, 1.26-2.35, P for trend <0.001). Wine and beer were not significantly associated with major GIB. The risk of GIB associated with NSAIDs/aspirin use increased with greater alcohol consumption (multivariable RR 1.37; 95% CI, 0.85-2.19 for 1-14g/day of alcohol, RR 1.75; 95% CI, 1.07-2.88 for ≥ 15g/day compared to nondrinkers). Smoking was not significantly associated with GIB. CONCLUSIONS: Alcohol consumption, but not smoking, was associated with an increased risk of major GIB. Associations were most notable for upper GIB associated with liquor intake. Alcohol appeared to potentiate the risk of NSAID-associated GIB. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27824864/A_Prospective_Study_of_Alcohol_Consumption_and_Smoking_and_the_Risk_of_Major_Gastrointestinal_Bleeding_in_Men_ L2 - http://dx.plos.org/10.1371/journal.pone.0165278 DB - PRIME DP - Unbound Medicine ER -