Barrett’s Esophagus

A new study published in the British Journal of Nutrition reports that alcohol consumption may not be correlated with the occurrence of Barrett’s Esophagus and Erosive Esophagitis.

 

Barret’s Esophagus (BE) is a condition where the flat lining squamous cells of the food pipe (esophagus) change into a more columnar morphology. Although not immediately cancerous, a small subset (1-5%) of BE patients develop esophageal cancer, usually over a long period of time. Erosive esophagitis (E), on the other hand, is an inflammation of the food pipe, which is not considered precancerous in nature. Both of these pathologies are associated with gastro-esophageal reflux disease (GERD).

Heavy alcohol consumption has been established as a risk factor for the development of esophageal cancer and GERD, but the association between alcohol intake and the development of BE or E is conflicting.

A recent article published in the British Journal of Nutrition by researchers in Italy reports findings from a multicenter case-controlled study, evaluating whether specific alcoholic beverages are associated with BE or E. A total of 1420 participants were recruited for the study: 339 with OE, 462 with E and 619 healthy controls without BE or E. Along with enquiries on lifestyle habits and GERD symptoms, each subject was asked to fill out a questionnaire reporting lifetime consumption of all types of alcoholic beverages, including wine, beer, and liquor. The frequency and years of consumption, age at the initiation of drinking, or years since cessation of drinking were also assessed.

Overall, the study found a slightly decreased risk of BE or E with low/moderate intake of wine and beer consumption. There was a slightly increased (although statistically non-significant) risk for the pathologies with liquor/spirit consumption, or in the case of heavy intake of any type of alcohol, but no apparent linear trends were noted.

The authors note that polyphenols, such as resveratrol, present in the skin of red grapes, and low levels of antioxidants present in beer, could account for the protective effects, although there is not a generally accepted hypothesis in the scientific community.

The authors compared their results to other studies which have shown a similar inverse association of low-to-moderate alcohol consumption to pathologies such as heart failure. The observations are also consistent with other studies which found no clear relationship between different kinds of alcohol consumption and the occurrence of BE or E. However, it also stands in contradiction with yet another set of studies, mostly conducted in Asia, which has shown a positive correlation between alcohol consumption and oeseophagitis. The authors point out that such contradicting results may be the result of heterogeneity among participating groups, lifestyle, and food habits.

 

Written By: Debapriya Dutta, PhD

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