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Risk factors for Barrett's oesophagus

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

risk factors

Several risk factors have been identified for the development of Barrett's oesophagus (1,2,3):

  • older age – > 50 years, rare in children
  • white race - uncommon in blacks and Asians
  • male sex - two to three times as common in men as in women
  • chronic heartburn
  • age<30 years at onset of GORD symptoms
  • hiatal hernia
  • erosive oesophagitis
  • obesity with intrabdominal fat distribution
  • metabolic syndrome
  • tobacco use
  • family history of GORD, Barrett's oesophagus or oesophageal adenocarcinoma
  • obstructive sleep apnoea
  • consumption of red meat and processed meat

Factors which might provide protection against Barrett's oesophagus include:

  • nonsteroidal antiinflammatory drugs - although this has been questioned and a study suggested that "use of NSAIDs was not associated with a reduced risk of Barrett's oesophagus. It is likely that the protective mechanism of NSAIDs on oesophageal adenocarcinoma occurs subsequent to the development of Barrett's oesophagus." (4)
  • gastric infection with Helicobacter pylori
  • consumption of a diet high in fruits and vegetables (1)

Known risk factors for the development of neoplasia in Barrett's oesophagus include:

  • advancing age
  • increasing length of Barrett's oesophagus
    • longer Barrett’s oesophagus segments are associated with increased risk of progression to oesophageal adenocarcinoma
  • central obesity
  • tobacco usage
  • lack of NSAIDs use
  • lack of PPI use
  • lack of statin use (2)

There is no evidence that alcohol consumption is associated with risk of Barrett's oesophagus (3).

Reference:

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