FAMILIAL AGGREGATION OF GASTROESOPHAGEAL REFLUX IN PATIENTS WITH BARRETTS-ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA

Background & Aims: Barrett's esophagus and adenocarcinoma are complica tions of gastroesophageal reflux disease. The aim of this study was to look for evidence of a familial predisposition to reflux. Methods: In dex patients with adenocarcinoma (n = 27), Barrett's esophagus (n = 40 ), and reflux esophagitis (n = 55) were recruited from tertiary care a nd community populations. Parents and siblings of patients (n = 243) a nd their spouses' relatives (n = 230) completed reflux symptom questio nnaires (response rate, 86%). Results: Reflux symptoms were significan tly more prevalent among parents and siblings of patients with adenoca rcinoma (43% vs. 23%) and Barrett's esophagus (46% vs. 27%) than spous e control relatives. No significant difference was found for the reflu x esophagitis group (33% vs. 29%). Reflux was more prevalent in siblin gs than spouses of patients with Barrett's esophagus (41% vs. 12%) and adenocarcinoma (40% vs. 6%), a difference that was not found with ref lux 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 predisposit ion to the development of reflux in families of patients with Barrett' s esophagus and esophageal adenocarcinoma. For uncomplicated reflux es ophagitis, environmental factors appear more important.