Familial aggregation of gastroesophageal reflux in patients with Barrett's esophagus and esophageal adenocarcinoma

Gastroenterology. 1997 Nov;113(5):1449-56. doi: 10.1053/gast.1997.v113.pm9352846.


Background & aims: Barrett's esophagus and adenocarcinoma are complications of gastroesophageal reflux disease. The aim of this study was to look for evidence of a familial predisposition to reflux.

Methods: Index patients with adenocarcinoma (n = 27), Barrett's esophagus (n = 40), and reflux esophagitis (n = 55) were recruited from tertiary care and community populations. Parents and siblings of patients (n = 243) and their spouses' relatives (n = 230) completed reflux symptom questionnaires (response rate, 86%).

Results: Reflux symptoms were significantly more prevalent among parents and siblings of patients with adenocarcinoma (43% vs. 23%) and Barrett's esophagus (46% vs. 27%) than spouse control relatives. No significant difference was found for the reflux esophagitis group (33% vs. 29%). Reflux was more prevalent in siblings than spouses of patients with Barrett's esophagus (41% vs. 12%) and adenocarcinoma (40% vs. 6%), a difference that was not found with reflux esophagitis (24% vs. 32%). Reflux was associated with obesity, 41% vs. 28% in the nonobese; smoking, 45% vs. 31% in nonsmokers; and men, 39% vs. 27% in women.

Conclusions: There may be a genetic predisposition to the development of reflux in families of patients with Barrett's esophagus and esophageal adenocarcinoma. For uncomplicated reflux esophagitis, environmental factors appear more important.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / complications*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Barrett Esophagus / complications*
  • Esophageal Neoplasms / complications*
  • Family
  • Female
  • Gastroesophageal Reflux / etiology
  • Gastroesophageal Reflux / genetics*
  • Humans
  • Male
  • Middle Aged
  • Risk Factors