TOPLINE:
An analysis of older adults revealed that subtypes of gastroesophageal reflux disease (GERD) such as erosive esophagitis, nonerosive reflux disease, and Barrett esophagus were associated with an increased risk for colonic neoplasia, with the risk more pronounced for colon polyps than for colorectal cancer.
METHODOLOGY:
- In symptomatic GERD, patients are commonly treated with long-term antisecretory therapy to suppress gastric acid production; however, sustained acid inhibition may undermine the stomach’s natural microbial barrier, permit oropharyngeal bacteria to colonize the lower gut, and thereby contribute to the development of colonic neoplasms such as polyps and colorectal cancer.
- Researchers conducted this case-control study to assess the associations between colon polyps or colorectal cancer and various subtypes of GERD.
- They analyzed Medicare data of 6,462,321 patients (mean age, 74.6 years; 53.9% women) who presented with erosive esophagitis (n = 74,938), nonerosive reflux disease (n = 1,960,409), Barrett esophagus (n = 51,099), or eosinophilic esophagitis (n = 834).
- These patients were compared with Medicare patients without GERD.
TAKEAWAY:
- Compared with not having GERD, having erosive esophagitis, Barrett esophagus, or nonerosive reflux disease was associated with significantly higher odds for colon polyps, with adjusted odds ratios [aOR] ranging from 1.70 to 3.96.
- The association between GERD and colorectal cancer was attenuated but still significant, with aORs ranging from 1.05 to 1.24.
- In contrast, having eosinophilic esophagitis showed a significant association with colon polyps (aOR, 3.52) but not with colorectal cancer.
IN PRACTICE:
“These findings lend support to the hypothesis that long-term use of antisecretory medications may constitute a risk for developing colon neoplasms,” the authors of the study wrote.
SOURCE:
This study was led by Amnon Sonnenberg, MD, Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon. It was published online in Alimentary Pharmacology & Therapeutics.
LIMITATIONS:
The study was limited to Medicare beneficiaries older than 65 years. Researchers had no data on obesity, smoking, or other potential confounders. Additionally, the analysis was limited by the absence of pharmacologic data, particularly regarding the effects of various antisecretory medications over prolonged periods.
DISCLOSURES:
No funding was reported for this study. The authors reported having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.