Abstract and Background
Background: Evidence regarding the association between alcohol consumption and the gastro-esophageal reflux disease (GERD) spectrum has been conflicting. We examined the association between alcohol consumption and erosive esophagitis and Barrett's epithelium in Japanese men.
Methods: The study population comprised 463 men subjects who had undergone an upper endoscopy at the Gastroenterology Division of Yokohama City University Hospital between August 2005 and July 2006. The presence of erosive esophagitis and Barrett's epithelium was diagnosed based on the Los Angeles Classification and the Prague C and M Criteria, respectively. We divided the study population into four groups: never drinkers, light drinkers (less than 25.0 g of ethanol per day), moderate drinkers (25.0 to 50.0 g of ethanol per day), and heavy drinkers (more than 50.0 g of ethanol per day). A linear regression of the logistic regression analysis was used to analyze the dose-response trends.
Results: Compared with never drinkers, light drinkers (less than 25.0 g ethanol per day), moderate drinkers (25.0 to 50.0 g per day), and heavy drinkers (more than 50.0 g per day) had ORs for erosive esophagitis of 1.110 (95% CI: 0.553 – 2.228, p = 0.7688), 1.880 (95% CI: 1.015 – 3.484, p = 0.0445) and 1.988 (95% CI: 1.120 – 3.534, p = 0.0190), respectively. These groups had ORs for Barrett's epithelium of 1.278 (95% CI: 0.752 – 2.170, p = 0.3643), 1.458 (95% CI: 0.873 – 2.433, p = 0.1500), and 1.912 (95% CI: 1.185 – 3.086, p = 0.0079), respectively. The odds ratios/grams (alcohol)/day of dose response trends for erosive esophagitis and Barrett's epithelium were 1.015 (95% CI: 1.004–1.026, p = 0.0066) and 1.012 (95% CI: 1.003–1.021, p = 0.0079), respectively.
Conclusion: These findings suggest that alcohol consumption in Japanese men tends to be associated with an increased risk of erosive esophagitis and Barrett's epithelium.
In cases with Barrett's epithelium, the resulting replacement of normal squamous epithelium with columnar epithelium can be seen in the distal esophagus as a salmon-pink colored area that is readily visible during endoscopic examinations. The proximal level of the squamocolumnar junction no longer coincides with the gastroesophageal junction in cases with Barrett's epithelium. Barrett's epithelium, which is recognized as a complication of erosive esophagitis, is recognized as a pre-malignant condition that may lead to the development of esophageal adenocarcinoma.[1,2] The incidence of esophageal adenocarcinoma is rapidly increasing in North America and Europe.[3,4,5] For esophageal carcinoma in Japan, however, the ratio of adenocarcinoma to squamous cell carcinoma is low, and no significant changes have been identified. As the prevalence of erosive esophagitis is increasing, further observation of Barrett's epithelium is required in Japan.
Although a strong statistical association between erosive esophagitis and a risk of Barrett's epithelium has been reported,[7,8,9,10] the roles of lifestyle risk factors, including alcohol consumption, are less well defined and remain controversial.[11,12,13,14,15] Therefore, we examined the association between alcohol consumption and the risk of erosive esophagitis and Barrett's epithelium in a retrospective cohort study of Japanese men.
The funding source had no involvement in the design, analysis, writing of the paper or decision to publish this work.
BMC Gastroenterol © 2008 Akiyama et al; licensee BioMed Central Ltd.
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Cite this: Alcohol Consumption Is Associated With an Increased Risk of Erosive Esophagitis and Barrett's Epithelium in Japanese Men - Medscape - Dec 11, 2008.