The prescribing of acid suppressants prior to the endoscopic diagnosis of Barrett's oesophagus and oesophagitis

Background: There has been a dramatic rise in incidences of Barrett's oesop hagus and oesophageal adenocarcinoma. It has been suggested that the introd uction and use of acid suppression therapy may be a factor in the rising in cidences of Barrett's oesophagus and oesophageal adenocarcinoma. Methods: This was a record linkage study, using a prescribing database and an endoscopy database. Patients who had undergone their first endoscopy dur ing the period 1992-1995 and received the diagnosis of Barrett's oesophagus or oesophagitis were identified. The prescribing of acid suppressants was compared for the 3 years prior to endoscopy, between those with Barrett's o esophagus and those with oesophagitis. Results: There was no significant difference between the Barrett's patients and the oesophagitis patients in the proportion that had been exposed to a cid suppression therapy (53.4% vs. 51.7%, P=0.704). The mean number of days of prescribing among those who had been exposed to acid suppression therap y was higher in the Barrett's group (340.5 vs. 237.0 days, P=0.001). Conclusions: Patients with Barrett's oesophagus have received more acid sup pressant therapy prior to diagnosis. The reasons for this are not clear. Ho wever, 46.6% of Barrett's patients have not been exposed to acid suppressan t therapy.