risk factors for Barrett's oesophagus

Last edited 05/2020 and last reviewed 02/2023

risk factors

Several risk factors have been identified for the development of Barrett's oesophagus (1,2,3):

  • older age – > 50 years, rare in children
  • white race - uncommon in blacks and Asians
  • male sex - two to three times as common in men as in women
  • chronic heartburn
  • age<30 years at onset of GORD symptoms
  • hiatal hernia
  • erosive oesophagitis
  • obesity with intrabdominal fat distribution
  • metabolic syndrome
  • tobacco use
  • family history of GORD, Barrett's oesophagus or oesophageal adenocarcinoma
  • obstructive sleep apnoea
  • consumption of red meat and processed meat

Factors which might provide protection against Barrett's oesophagus include:

  • nonsteroidal antiinflammatory drugs - although this has been questioned and a study suggested that "use of NSAIDs was not associated with a reduced risk of Barrett's oesophagus. It is likely that the protective mechanism of NSAIDs on oesophageal adenocarcinoma occurs subsequent to the development of Barrett's oesophagus." (4)
  • gastric infection with Helicobacter pylori
  • consumption of a diet high in fruits and vegetables (1)

Known risk factors for the development of neoplasia in Barrett's oesophagus include:

  • advancing age
  • increasing length of Barrett's oesophagus
    • longer Barrett’s oesophagus segments are associated with increased risk of progression to oesophageal adenocarcinoma
  • central obesity
  • tobacco usage
  • lack of NSAIDs use
  • lack of PPI use
  • lack of statin use (2)

There is no evidence that alcohol consumption is associated with risk of Barrett's oesophagus (3).

Reference: