Analysis of Barrett's esophagus and risk factors

Background
Although it has been reported that there is a relationship between Helicobacter pylori (HP) and Barrett's esophagus (BE), but there are few reports on the effect of HP eradication therapy on BE now that HP eradication therapy has become common. It is necessary to analyze the risk factors for BE taking into account HP infection status.
Methods
We analyzed the correlations among factors, including HP infectious status, endoscopic images, and BE ≥1 cm, in 10,122 individuals (5,962 males; mean age=52.9±9.9) who underwent esophagogastroduodenoscopy for a medical check-up.
Results
The prevalence of BE, long-segment BE, and esophageal adenocarcinoma was 22.5%, 0.014%, and 0%, respectively. Logistic regression analysis revealed the following risk factors for BE: hiatal hernia (odds ratio [OR]: 2.90), female sex (OR: 0.52), social drinking (OR: 0.76), after HP eradication therapy (OR: 1.34), age ≥50 years (OR: 1.15), bile acid reflux (OR: 1.18), and NSAIDs use (OR: 1.31). Interestingly, reflux esophagitis (RE) was more common in HP-negative subjects (17.2%) than after HP eradication therapy (11.8%, P<0.00001), but BE was more common in after HP eradication therapy (26.9%) than HP-negative subjects (20.6%, P<0.0001). Subgroup analysis revealed that BE was more common in most of the factors, except PPI use, H2RA use, and without gastric atrophy.
Conclusion
HP eradication is a risk for BE.