The association of body mass index with Barrett's oesophagus

Abstract

Sirs, We read the article entitled ‘The association of body mass index with Barrett's oesophagus’ by Stein et al.1 with great interest. The authors state in the first sentence of the summary that ‘Obesity has been linked to gastro-oesophageal reflux disease symptoms and oesophageal adenocarcinoma; however, there is no published evidence for an association with Barrett's oesophagus’. I would like to draw attention to our article entitled ‘Lifestyle factors and Barrett's Esophagus’.2 In a study of 136 Barrett's patients from Ninewells Hospital Dundee we reported that in the younger patients (aged <50 years) 31% of men and 71% of women had a body mass index (BMI) > 30 compared with 11% and 13%, respectively, for the general population. In those aged more than 50 years 14% of men and 19% of women have a BMI > 30. These results suggest that obesity may be a risk for Barrett's oesophagus in younger but not older Barrett's patients. We also speculated that, in younger patients, this finding could be secondary to an association between obesity and gastro-oesophageal reflux which itself has been claimed to be the main causal factor in Barrett's development.3