Risk of Barrett's oesophagus, oesophageal adenocarcinoma and reflux oesophagitis and the use of nitrates and asthma medications

Abstract

Objective. To investigate the relationship between use of asthma medication and nitrates and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma. Material and methods. Data were collected on use of asthma medication and nitrates at least 1 year before interview from patients with reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma. Associations between use of asthma medications and nitrates and the risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma were estimated using multiple logistic regression. Results. Nine hundred and forty-one subjects were recruited: 230 reflux oesophagitis, 224 Barrett's oesophagus, 227 oesophageal adenocarcinoma patients and 260 population controls. Barrett's oesophagus patients were more likely than controls to have had a diagnosis of asthma (odds ratio 2.15, 95% confidence interval 1.15–4.03) and to have used asthma medications (odds ratio 2.13, 95% confidence interval 1.09–4.16). No significant associations were observed between use of asthma medication or nitrates and reflux oesophagitis or oesophageal adenocarcinoma. Conclusions. Gastro-oesophageal reflux symptoms appear to confound the association between asthma medication use and Barrett's oesophagus. However, it is possible that asthma medications may increase the risk of Barrett's oesophagus by other mechanisms.

Key Words::

• Anti-asthmatic agents
• asthma
• Barrett's oesophagus
• oesophageal adenocarcinoma
• oesophageal disorders
• nitric oxide donors
• nitrates
• reflux oesophagitis

Acknowledgements

We appreciate the contributions made by the study participants and their families. We thank the clinicians who were contacted throughout the study period and their secretaries for administrative support. We acknowledge the contribution of Miss Siobhan Reynolds, Ms Majella Gallagher, Ms Carol Anderson and Mr Martin McAnaespie and Dr Damian McManus. Thanks to the Ulster Cancer Foundation, the Northern Ireland Cancer Registry and the National Cancer Registry Ireland for their support and involvement in the research. The FINBAR study group members include L.J. Murray (Queen's University Belfast), L.A. Anderson (Queen's University Belfast), B.T. Johnston (Belfast Health & Social Care Trust), R.G.P. Watson (Belfast Health & Social Care Trust), J. McGuigan (Belfast Health & Social Care Trust), H.R. Ferguson (Belfast Health & Social Care Trust), S.J. Murphy (Craigavon Area Hospital), J.V. Reynolds (St James' Hospital, Dublin) and H. Comber (National Cancer Registry of Ireland).

Grant support: This research was funded by an Ireland–Northern Ireland Co-operation Research Project Grant sponsored by the Northern Ireland Research & Development Office, and the Health Research Board, Ireland. Additional funding was provided by the Ulster Cancer Foundation and the Charitable Fund of the Royal Groups of Hospitals, Belfast.

Declaration of interest : The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.