Reflux disease ups risk of colonic neoplasia

The presence of reflux disease, no matter the type, appears to elevate the risk for colonic neoplasia, suggests a recent study.

Researchers used the University of Pennsylvania Health System (UPenn) electronic database to search for case-control studies and examine the occurrence of eosinophilic esophagitis (EoE), nonerosive reflux disease (NERD), erosive esophagitis, or Barrett’s esophagus in patients with colon polyps or colorectal cancer (CRC).

Patients with CRC or colon polyps were compared with control participants, and the odds ratios (ORs) were calculated using multivariate logistic regressions to adjust for the confounding influences of demographic characteristics (ie, age, sex, and race/ethnicity).

The UPenn database contained a total of 89,100 patients who underwent a colonoscopy and esophagogastroduodenoscopy between January 2000 and December 2023. Of these, 35,841 had a diagnosis of colon polyps and 3,228 of CRC.

Overall, 2,137 patients were diagnosed with EoE, 18,223 with erosive esophagitis, 57,397 with NERD, and 6,614 with Barrett’s esophagus.

Colon polyps significantly correlated with EoE (OR, 1.17, 95 percent confidence interval [CI], 1.07‒1.28), erosive esophagitis (OR, 1.71, 95 percent CI, 1.65‒1.77), NERD (OR, 1.76, 95 percent CI, 1.71‒1.81), and Barrett’s esophagus (OR, 1.80, 95 percent CI, 1.71‒1.90).

On the other hand, CRC showed a significant association with Barrett’s esophagus (OR, 1.22, 95 percent CI, 1.08‒1.33) but not with other types of esophageal disease.

“Long-term inhibition of gastric acid secretion by antisecretory medication may constitute a risk factor for the occurrence of colon polyps and possibly CRC,” the researchers said.