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• W3210180094 abstract "Introduction: The association between gastroesophageal reflux disease (GERD) and hormone replacement therapy (HRT) in post-menopausal women has been scarcely studied. Specifically, the reported effect of estrogen hormonal therapy on GERD and its complications has been contradictory in the literature. The aim of our study was to determine the risk of GERD and its complications in post-menopausal women on HRT (estrogen or progestin) versus those who are not taking HRT. Methods: We performed a population-based analysis using the IBM Explorys database (1999-2021), a pooled, national, de-identified dataset of over 72 million unique patients from 26 health care networks and 300 hospitals. Inclusion criteria for post-menopausal women included: age >55 with a diagnosis code of “postmenopausal state”. The effect of FDA approved post-menopausal hormonal preparations categorized as estrogen-only or progestin-only medications on GERD and its complications, such as Barrett’s esophagus, esophageal stricture and esophageal cancer was assessed. Pregnancy, foregut surgery, esophageal dysmotility disorders and delayed gastric emptying were excluded. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to compare outcomes between post-menopausal women on HRT versus those on no HRT. A multivariable logistic regression analysis was conducted. Results: A total of 407,150 (39%) post-menopausal women had GERD. The use of estrogen only hormonal preparation in post-menopausal women was associated with increased risk of GERD (OR=1.27, p< 0.0001), Barrett’s esophagus (1.44 p< 0.0001), esophageal stricture (1.41, p< 0.0001) and esophageal cancer (1.60, p< 0.0001) when compared to post-menopausal women not on HRT. The use of progestin only preparation was associated with increased risk of GERD (1.31, p< 0.0001) and Barrett’s esophagus (1.43, p< 0.0001) (Figure 1). Multivariate analysis showed that the use of estrogen-only preparations had a statistically significant increase in GERD (6.33, p< 0.0001) and Barrett’s esophagus (6.23, p< 0.0001) in post-menopausal women. Estrogen was a stronger risk factor for GERD and Barrett’s esophagus than smoking, alcohol, age >65, obesity, and being white (Table 1). This effect was not seen with progestin-only preparations. Conclusion: Postmenopausal women on estrogen only as HRT have a higher risk of developing GERD and Barrett’s esophagus as compared to post-menopausal women on no HRT or those on progestin preparations. The use of progestin preparations may alter that risk.Figure 1.: Comparison of risk for GERD and its complications between post-menopausal women (age>55) on estrogen-only or progestin-only hormone replacement therapy (HRT) versus post-menopausal women not on any HRT.Table 1.: Comparison of the risk factors for GERD and Barrett’s esophagus in post-menopausal women, using multi-regression analysis." @default.
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• W3210180094 date "2021-10-01" @default.
• W3210180094 modified "2023-09-23" @default.
• W3210180094 title "S355 Effect of Hormone Replacement Therapy on Gastroesophageal Reflux Disease and Barrett’s Esophagus in Post-Menopausal Women" @default.
• W3210180094 doi "https://doi.org/10.14309/01.ajg.0000773892.91236.da" @default.
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