Mayo Clinic Researchers: Family History Identified As New Risk Factor For Heartburn

ROCHESTER, MINN. — Mayo Clinic researchers have concluded that family history, possibly through a genetic link, and obesity are major independent risk factors for heartburn and acid regurgitation, both symptoms of gastroesophageal reflux disease.

Upwards of 20 percent of American and European populations are estimated to experience heartburn or acid regurgitation at least once a week. Chronic heartburn and acid reflux may lead to Barrett’s esophagus, which may evolve into esophageal cancer.

In one of the few population-based studies on this subject — published recently in The American Journal of Medicine — Mayo Clinic researchers went outside the laboratory to survey 1,524 residents of Olmsted County, Minn. Participants were asked if any members of their immediate family (parents, siblings or children) had significant heartburn or disease of the esophagus or stomach.

Those who responded affirmatively were twice as likely to report that they themselves experienced heartburn or acid regurgitation. Participants with a higher body mass index (obesity), a past history of cigarette smoking or a higher consumption of alcohol also were at increased risk for gastroesophageal reflux symptoms.

"That family history was discovered as a risk factor suggests that there may be a genetic component to gastroesophageal reflux disease," says G. Richard Locke III, M.D., a gastroenterologist who led the team of Mayo Clinic researchers. "The other risk factors do not explain the familial ‘clustering’ of this disorder."

Apart from this study, Dr. Locke noted that several case reports have been published that describe families with multiple members who have experienced various forms of gastroesophageal reflux disease in up to four generations.

"This disorder likely is a combination of nature and nurture," Dr. Locke says. "However, more research into the human genome is needed to determine if indeed there is a gene that passes gastroesophageal reflux disease from one generation to the next."

Dr. Locke and colleagues further note that obesity, smoking and alcohol use are well recognized risk factors for reflux as well as other diseases. "We still need to prove, however, that modifying these factors has an effect on reflux," he says. "That is the next step."

For more information on this study, see the June 1999 edition of The American Journal of Medicine, or the May 1999 edition of The American Journal of Gastroenterology.