Familial clustering of reflux symptoms

OBJECTIVE: A number of case reports describe multiple family members with g astroesophageal reflux disease and Barrett's esophagus. The wider importanc e of familial factors in gastroesophageal reflux disease has not been estab lished. Therefore, we have studied the prevalence of reflux symptoms and me dication use among relatives of patients with documented gastroesophageal r eflux disease. METHODS: A postal questionnaire study of the first degree relatives of six groups of matched patients. The groups comprised patients with 1) no dyspep tic symptoms; 2) reflux symptoms and a normal pH study; 3) reflux symptoms, an abnormal pH study, and a lower esophageal sphincter (LOS) pressure more than 10 mm Hg; 4) reflux symptoms, an abnormal pH study, and a LOS pressur e less than 10 mm Hg; 5) Barrett's esophagus; and 6) peptic stricture. RESULTS: Four hundred eighteen subjects replied (78% response). Infrequent reflux symptoms were equally common in all groups of relatives. Frequent re flux symptoms, however, were more common among relatives of patients with a n abnormal pH study and normal (26%, p = 0.007) or low LOS pressure (27%, p = 0.01) or Barrett's esophagus (30%, p = 0.003), compared with relatives o f nondyspeptic patients (9%). Frequent reflux symptoms were no more common among relatives of patients with a normal pH study (16%) or peptic strictur e (18%). Reflux medication use showed a similar pattern. CONCLUSIONS: Familial clustering of reflux symptoms is seen in relatives of patients with reflux symptoms and increased esophageal acid exposure and i n relatives of patients with Barrett's esophagus. (C) 1999 by Am. Cell. of Gastroenterology.