Alcohol type linked to Barrett's esophagus risk

Wine seems to protect against the development of Barrett's esophagus, as does higher educational status, according to a study published in the March issue of Gastroenterology.

Patients with Barrett's esophagus have a 30- to 125-fold increased risk of developing esophageal cancer when compared to the general population, Dr. Ai Kubo, of Kaiser Permanente, Oakland, California, and colleagues report. "Little is known regarding the effect of alcohol on Barrett's esophagus, especially related to alcohol types."

The researchers conducted a study with Kaiser Permanente Northern California patients and used data from 320 patients with a new diagnosis of Barrett's esophagus. These individual were matched to 316 subjects with gastroesophageal reflux disease (GERD) and to 317 population controls.

Each participant underwent in-person interviews and physical examinations. Information was collected on GERD symptoms, medication use, income, education, medical history, and tobacco use.

Total alcohol consumption was not significantly associated with the risk of Barrett's esophagus. However, stratification by alcohol type revealed an inverse association between consumption of one glass of wine per day, on average, and the risk of Barrett's esophagus compared with non-drinkers.

Wine drinkers were more likely to have college degrees and to regularly take vitamin supplements than those who drank beer or liquor. However, consideration of these factors and GERD symptoms did not eliminate the inverse association between wine consumption and Barrett's esophagus.

A strong association was also observed between education status and a lower risk of Barrett's esophagus.

One key factor may be compounds such as polyphenol found in red wine "that have important protective action on biomarkers of oxidative stress," Dr. Kubo's team explains. "Human and animal data suggest antioxidants may decrease the risk of Barrett's esophagus and esophageal adenocarcinoma," they note.

"Drinking wine may reduce the oxidative damage caused by GERD, thereby either decreasing the risk of esophagitis among GERD patients or decreasing the chance of Barrett's esophagus developing among patients with esophagitis."

SOURCE: Gastroenterology, March 2009.